Standard General Medical Services Contract (12.03.04)
STANDARD GENERAL MEDICAL SERVICES
CONTRACT
This contract is issued by the
Scottish Executive Health Department
Standard General Medical Services Contract (12.03.04)
CONTENTS
Part.
Headings
Clause No.
PART 1
DEFINITIONS AND INTERPRETATION
0-4
PART 2
RELATIONSHIP BETWEEN THE PARTIES
5-12
PART 3
NHS CONTRACT
13
PART 4
COMMENCEMENT OF THE CONTRACT
14
DURATION OF THE CONTRACT
15-19
PART 5
WARRANTIES
20-23
PART 6
LEVEL OF SKILL
24
PROVISION OF SERVICES
25-44
PART 7
ESSENTIAL SERVICES
45-51
PART 8
ADDITIONAL SERVICES
52-81
PART 9
OUT OF HOURS SERVICES
82-85
PART 10
OPT OUTS OF ADDITIONAL AND
OUT OF HOURS SERVICES
88-155
PART 11
ENHANCED SERVICES
156-160
PART 12
PATIENTS
161-268
PART 13
PRESCRIBING AND DISPENSING
269-296
PART 14
PERSONS WHO PERFORM SERVICES
297- 378
PART 15
RECORDS, INFORMATION, NOTIFICATION
AND RIGHTS OF ENTRY
379-416
PART 16
CERTIFICATES
417-418
PART 17
PAYMENT UNDER THE CONTRACT
419-421
PART 18
FEES AND CHARGES
429-433
PART 19
CLINICAL GOVERNANCE
434
PART 20
INSURANCE
435-438
PART 21
GIFTS
439-444
PART 22
COMPLIANCE WITH LEGISLATION AND
2
Standard General Medical Services Contract (12.03.04)
GUIDANCE
445
PART 23
COMPLAINTS
446-463
PART 24
DISPUTE RESOLUTION PROCEDURES
464-474
PART 25
VARIATION AND TERMINATION OF
PART 26
THE CONTRACT
475-546
NON-SURVIVAL OF TERMS
547
ENTIRE AGREEMENT
548-549
GOVERNING LAW AND JURISDICTION
550-552
WAIVER, DELAY OR FAILURE TO EXERCISE
RIGHTS
553
FORCE MAJEURE
554-557
SEVERANCE
558-560
SERVICE OF NOTICE
561-564
SCHEDULES
SCHEDULE 1
CONTRACTOR’S DETAILS (INDIVIDUAL)
SCHEDULE 1
CONTRACTOR’S DETAILS (PARTNERSHIP)
SCHEDULE 1
CONTRACTOR’S DETAILS (COMPANY)
SCHEDULE 2
SIGNATURES OF THE PARTIES TO THE AGREEMENT
SCHEDULE 3
INFORMATION TO BE INCLUDED IN PRACTICE
LEAFLETS
SCHEDULE 4
CLOSURE NOTICE
SCHEDULE 5
PLAN FOR IMPROVEMENT OF PREMISES
SCHEDULE 6
PAYMENT SCHEDULE
3
Standard General Medical Services Contract (12.03.04)
DATE [
]
(1) The Health Board whose name and address appears at Schedule 1 to
this Contract (called “the HB”) and
(2) The contractor whose name appears at Schedule 1 to this Contract
(called “the Contractor”)
WHEREAS
A. The HB is a statutory body established by order made under
section 2(1)(a) of the National Health Service (Scotland) Act
1978. It is the duty of the HB to exercise its powers so as to
provide or secure the provision of primary medical services as
respects their area.
B. In order to achieve this object, the HB is empowered by the
National Health Service (Scotland) Act 1978, and the regulations
made thereunder1, to enter into a general medical services
contract with specified categories of person.
C. The Contractor falls within one of the specified categories of
person.
D. The HB and the Contractor wish to enter into a general medical
services contract under which the Contractor is to provide
primary medical services and other services in accordance with
the provisions of this Contract.
1
The National Health Service (General Medical Services Contracts) Regulations 2004. 1
.
4
Standard General Medical Services Contract (12.03.04)
THEREFORE the parties HAVE AGREED and DO HEREBY
AGREE as follows
PART 12
DEFINITIONS AND INTERPRETATION
The following terms and phrases shall have the following meanings for
the purposes of this Contract:
“the Act” means the National Health Service (Scotland) Act 1978;
“1977 Act” means the National Health Service Act 1977;
“2003 Order” means the General and Specialist Medical Practice
(Education, Training and Qualifications) Order 2003;
“2004 Act” means the Primary Medical Services (Scotland) Act 2004;
“additional services” means one or more of(a) cervical screening services;
(b) contraceptive services;
(c) vaccinations and immunisations;
(d) childhood vaccinations and immunisations;
(e) child health surveillance services;
(f) maternity medical services; and
(g) minor surgery;
2
Part 1 is not required by the Regulations, but is recommended.
5
Standard General Medical Services Contract (12.03.04)
“adjudicator” means the Scottish Ministers or a panel of 3 persons
appointed by the Scottish Ministers in accordance with paragraph 91 of
Schedule 5 of the Regulations
“appliance” means an appliance which is included in a list for the time
being approved by the Scottish Ministers for the purposes of section 27(1)
of the Act;
“approved medical practice” shall be construed in accordance with
section 11 of the Medical Act 1983;
“area medical committee” means the committee of that name recognised
under section 9 of the Act (local consultative committees) in the area of the
Health Board;
“armed forces GP” means a medical practitioner who is employed on a
contract of service by the Ministry of Defence, whether or not as a member
of the United Kingdom Armed Forces of Her Majesty
“assessment panel” means a committee or sub-committee of a Health
Board (“the first Health Board”) (other than the Health Board (“the second
Health Board”) which is a party or prospective party to the contract in
question) appointed by the first Health Board at the request of the second
Health Board to exercise functions under paragraph 2. 3, 4 or 5 of Schedule
2 or paragraph 31 or paragraph 35 of Schedule 5 to the Regulations and
which shall consist of
a) the Chief Executive of the first Health Board or an Executive Director of
that Health Board nominated by that Chief Executive;
b) a person representative of patients in an area other than that of the
second Health Board; and
6
Standard General Medical Services Contract (12.03.04)
c) a person representative of the area medical committee which does not
represent practitioners in the area of the second Health Board;
“care home service” has the same meaning as in section 2(3) of the
Regulation of Care (Scotland) Act 2001;
“CCT” means Certificate of Completion of Training awarded under
article 8 of the 2003 Order, including any such certificate awarded in
pursuance of the competent authority functions of the Postgraduate
Medical Education and Training Board specified in article 20(3)(a) of that
Order;
“cervical screening services” means the services described in clause 68;
“child” means a person who has not attained the age of 16 years;
“child health surveillance services” means the services described in clause
76;
“childhood
vaccinations
and
immunisations”
means
the
services
described in clauses 73 to 74;
“closed” in relation to the Contractor’s list of patients, means closed to
application for inclusion in the list of patients other than from immediate
family members of registered patients;
“contraceptive services” means the services described in clause 70;
“Contract” means this Contract between the HB and the Contractor
named in Schedule 1;
7
Standard General Medical Services Contract (12.03.04)
“Contractor’s list of patients” means the list prepared and maintained by
the HB under clause 166;
“core hours” means the period beginning at 8am and ending at 6.30pm on
any working day
“disease” means a disease included in the list of three-character categories
contained in the tenth revision of the International Statistical Classification
of Diseases and Related Health Problems (published by the World Health
Organisation, 1992 ISBN 92 4 1544 19 8 (v.I) NLM Classification WB 15).
“dispensing services” means the provision of drugs, medicines and
appliances;
“disqualified” means, unless the context otherwise requires, local or
national disqualification by the Tribunal (or a decision under provisions in
force in England, wales or Northern Ireland corresponding to local or
national
disqualification),
but
does
not
include
conditional
disqualification;
“Drug Tariff” means the statement published under regulation 9
(payments to pharmacists and standards of drugs and appliances) of the
Pharmaceutical Regulations;
“enhanced services” meansa) services other than essential services, additional services or out of hours
services; or
b) essential services, additional services or out of hours services or an
element of such a service that a contractor agrees under the contract
to provide in accordance with specifications set out in a plan, which
requires of the contractor an enhanced level of service provision
8
Standard General Medical Services Contract (12.03.04)
compared to that which it needs generally to provide in relation to
that service or element of service;
“essential services” means the services described in clauses 45 to 51;
“general medical practitioner” means(a) from the coming into force of article 10 of the 2003 Order, a medical
practitioner whose name is included in the General Practitioner
Register otherwise than by virtue of paragraph 1(d) of Schedule 6 of
that Order; and
(b) until the coming into force of that article, a medical practitioner
who is eitheri. until the coming into force of paragraph 22 of Schedule 8 to
the 2003 Order, suitably experienced within the meaning of
section 21(2) of the Act, section 31(2) of the National Health
Service Act 1977 or Article 8(2) of the Health and Personal
Social Services (Northern Ireland) Order 1978, or
ii. upon the coming into force of paragraph 22 of Schedule 8 to
the 2003 Order, an eligible general practitioner pursuant to
that paragraph other than by virtue of having an acquired
right under paragraph 1(d) of Schedule 6 to the 2003 Order;
“General Practitioner Register” means the register kept by the General
Medical Council under article 10 of the 2003 Order;
“global sum” has the meaning given to it in the GMS Statement of Financial
Entitlements;
“GMS Statement of Financial Entitlements” means the directions given by
the Scottish Ministers under section 17M of the Act (payments by Health
Boards under general medical services contracts);
9
Standard General Medical Services Contract (12.03.04)
“GP Registrar”—
(a) until the coming into force of article 5 of the 2003 Order, means a
medical practitioner who is being trained in general practice by a
general medical practitioner who—
i. has been approved for that purpose by the Joint Committee
on Postgraduate Training for General Practice under
regulation 7 of the National Health Service (Vocational
Training
for
General
Medical
Practice)
(Scotland)
Regulations 1998, and
ii. performs primary medical services, and
(b) from the coming into force of that article, means a medical
practitioner who is being trained in general practice by a GP Trainer
whether as part of training leading to the award of a CCT or
otherwise;
“GP Trainer” means a general medical practitioner who is―
a) until the coming into force of article 4(5)(d) of the 2003 Order,
approved as a GP Trainer by the Joint Committee on
Postgraduate Training for General Practice under regulation 7 of
the National Health Service (Vocational Training for General
Medical Practice) (Scotland) Regulations 1998; or
b) from the coming into force of that article, approved by the
Postgraduate Medical Education and Training Board under
article 4(5)(d) of the 2003 Order for the purposes of providing
training to a GP Registrar under article 5(1)(c)(i) of that Order;
“Health and Social Services Board” means a Health and Social Services
Board established under the Health and Personal Social Services
(Northern Ireland) Order 1972;
10
Standard General Medical Services Contract (12.03.04)
“Health and Social Services Trust” means a Health and Social Services
Trust established under Article 10(1) of the Health and Personal Social
Services (Northern Ireland) Order 1991;
“Health Authority” means a Health Authority established under section 8 of
the 1977 Act;
“health care professional” has the same meaning as in section 17L(5) of the
Act, and “health care profession” shall be construed accordingly;
“health service body” means any person or body referred to in section
17A(2) of the Act and includes, except where otherwise expressly
provided, any person who is to be regarded as a health service body in
accordance with regulation 10 (health service body status) of the
Regulations;
“immediate family member” means(a) a spouse,
(b) a person (whether or not of the opposite sex) whose
relationship
with
the
registered
patient
has
the
characteristics of the relationship between husband and wife,
(c) a parent or step-parent,
(d) a son,
(e) a daughter, or
(f) a child of whom the registered patient isa. the guardian, or
b. the carer duly authorised by the local authority to
whose care the child has been committed under the
Children (Scotland) Act 1995; or
(g) a grandparent;
11
Standard General Medical Services Contract (12.03.04)
“independent nurse prescriber” means a person(a) who is either engaged or employed by the contractor or,
where the contractor is a partnership, is a partner in that
partnership
(b) who is registered in the Nursing and Midwifery Register,
and
(c) in respect of whom an annotation is also recorded in that
register signifying that the person is qualified to order drugs,
medicines and appliances from(i) the Nurse Prescribers’ Formulary for District Nurses and
Health Visitors in Part 8B of the Drug Tariff, or
(ii) the Nurse Prescribers’ Extended Formulary in Part 8C of
the Drug Tariff;
“licensing authority” shall be construed in accordance with section 6(3) of
the Medicines Act 1968;
“licensing body” means any body that licenses or regulates any
profession;
“limited partnership” means a partnership registered under the Limited
Partnerships Act 1907;
“list” has, unless the context otherwise requires, the meaning assigned to it
in section 29(8) of the Act and includes a list corresponding to such a list in
England, Wales or Northern Ireland;
“Local Health Board” means a Local Health Board established under
section 16BA of the 1977 Act;.
12
Standard General Medical Services Contract (12.03.04)
“local or national disqualification” has the meaning indicated in section
29B(2) of the Act;
“mandatory term” means a term required to be included in the Contract
by the Regulations;
“maternity medical services” means the services described in clause 78;
“medical card” means a card issued by a Health Board, Primary Care trust,
Local Health Board, Health Authority, or Health and Social Services Board to a
person for the purpose of enabling that person to obtain, or establishing
the person’s title to receive, primary medical services;
“medical officer” means a medical practitioner who is—
a) employed or engaged by the Department for Work and Pensions,
or
b) provided by an organisation in pursuance of a contract entered
into with the Secretary of State for Work and Pensions;
“Medical Register” means the registers kept under section 2 of the Medical
Act 1983;
“minor surgery” means the services described in clauses 80 to 81;
“national disqualification” means—
(a) a national disqualification by the Tribunal; or,
(b) a decision under the provisions in force in England, Wales or
Northern Ireland corresponding to a national disqualification by the
Tribunal.
13
Standard General Medical Services Contract (12.03.04)
“NHS contract” means a contract
a) which is a general medical services contract under section 17J of the Act;
and
b) which is a NHS contract within the meaning of section 17A(3) of the
Act as a consequence of the contractor being regarded as a health service
body pursuant to Regulation 10(1) or (5)
“NHS dispute resolution procedure” means the procedure for resolution
of disputes specified in paragraphs 91 and 92
of Schedule 5
to the
Regulations;
“NHS foundation trust” has the same meaning as in section 1 of the
Health and Social Care (Community Health and Standards) Act 2003;
“NHS trust” means, in England and Wales, a National Health Service trust
established under section 5 of the National Health Service and
Community Care Act 1990;
“normal hours” means those days and hours specified in the Contract as
being the days on which and the times at which services under the
Contract will normally be available and may be different for different
services;
“Nursing and Midwifery Register” means the register maintained by the
Nursing and Midwifery Council under the Nursing and Midwifery Order
2001;
“open” in relation to the Contractor’s list of patients, means open to
applications from patients in accordance with clauses 171 to 176;
14
Standard General Medical Services Contract (12.03.04)
“opt out notice” means a notice given under clause 90 to opt out
permanently or opt out temporarily of the provision of the additional service;
“out of hours arrangement” means an arrangement under clause 351 ;
“out of hours opt out notice” means a written notice served on the HB
specifying that the Contractor wishes to terminate its obligation to provide
out of hours services pursuant to clause 130 or 138 (as the case may be);
“out of hours period” means(a) the period beginning at 6.30pm on any day from Monday to
Thursday and ending at 8am on the following day;
(b) the period between 6.30pm on Friday and 8am on the
following Monday; and
(c) Christmas Day, New Year’s Day and any other public or
localholiday
and “part “ of an out of hours period means any part of one or more of
periods described in paragraphs (a) to (c);
“out of hours services” means services required to be provided in all or
part of the out of hours period which(a) would be essential services if provided in core hours; or
(b) are included in the Contract as additional services funded
under the global sum.
“parent” includes, in relation to any child, any adult who, in the opinion of
the Contractor, is for the time being discharging in respect of that child the
obligations normally attaching to a parent in respect of a child;
“patient” means-
15
Standard General Medical Services Contract (12.03.04)
(a) a registered patient,
(b) a temporary resident,
(c) persons to whom the Contractor is required to provide
immediately necessary treatment under clause 46.3 or 49,
(d) any other person to whom the Contractor has agreed to
provide services under the Contract;
(e) any person for whom the Contractor is responsible under
regulation 31 of the Regulations; and
(f) any other person to whom the Contractor is responsible
under arrangements made with another contractor of the
kind referred to in clause 363;
“permanent opt out” in relation to the provision of an additional service that
is funded through the global sum, means the termination of the obligation
under the Contract for the Contractor to provide that service; and “opt out
permanently” shall be construed accordingly;
“permanent opt out notice” means an opt out notice to opt out permanently;
“Pharmaceutical Regulations” means the National Health Service
(Pharmaceutical Services) (Scotland) Regulations 1995;
“pharmacist” means –
a) a registered pharmacist within the meaning of the Medicines Acxt 1968
who provides pharmaceutical services, or
b) a person lawfully conducting a retail pharmacy business in accordance
with section 69 of that Act who provides such services, or
c) a supplier of appliances,
who is included in the list of a Health board under section 27 of the Act;
“POM Order” means the Prescription Only Medicines (Human Use) Order
1997;
16
Standard General Medical Services Contract (12.03.04)
“practice” means the business operated by the Contractor for the purpose
of delivering services under the Contract;
“practice area” means the area referred to in clause 162;
“practice leaflet” means a leaflet drawn up in accordance with clause 391;
“practice premises” means an address specified in the Contract as one at
which services are to be provided under the Contract;
“preliminary opt out notice” means a notice given under clause 88 that the
Contractor wishes to opt out temporarily or opt out permanently of the
provision of an additional service;
“prescriber” means(a) a medical practitioner;
(b) an independent nurse prescriber; and
(c) a supplementary prescriber;
who is either engaged or employed by the contractor or, where the
contractor is a partnership, is a partner in that partnership
“prescription form” means a form provided by the HB and issued by a
prescriber to enable a person to obtain pharmaceutical services;
“prescription only medicine” means a medicine referred to in article 3 of
the POM Order;
“ Primary Care trust” means a Primary Care trust established under
section 16A of the 1977 Act;
17
Standard General Medical Services Contract (12.03.04)
“primary medical services performers list” means the list of primary
medical services performers prepared in accordance with regulations
made under section 17P of the Act (persons performing primary medical
services);
“public or local holiday” means a public or local holiday which is agreed
in writing between the HB and the Contractor and which shall, in
aggregate, be no less than those available to NHS staff employed by the
HB;
“registered patient” means(a) a person who is recorded by the HB as being on the Contractor’s list of
patients; or
(b) a person whom the Contractor has accepted for inclusion on its list of
patients, whether or not notification of that acceptance has been
received by the HB and who has not been notified by the HB as having
ceased to be on that list;
“Regulations” means The National Health Service (General Medical
Services Contracts) (Scotland) Regulations 2004;
“relevant register” means—
a) in relation to a nurse, the Nursing and Midwifery Register; and
b) in relation to a pharmacist, the register maintained in pursuance of
section 2(1) of the Pharmacy Act 1954 or the register maintained in
pursuance of articles 6 and 9 of the Pharmacy (Northern Ireland) Order
1976;
“restricted availability appliance” means an appliance which is approved
for particular categories of persons or particular purposes only;
18
Standard General Medical Services Contract (12.03.04)
“Scheduled drug” means(a) a drug, medicine or other substance specified in any directions
given by the Scottish Ministers under section 17N(6) of the Act as
being a drug, medicine or other substance which may not be
ordered for patients in the provision of medical services under the
Contract, or
(b) except where the conditions in clause 276 are satisfied, a drug,
medicines or other substance which is specified in any directions
given by the Scottish Ministers under section 17N(6) of the Act as
being a drug, medicine or other substance which can only be
ordered for specified patients and specified purposes.
“section 17C provider” means a person or body who is providing primary
medical services in accordance with an agreement pursuant to section 17C
of the Act;
“supplementary prescriber” means a person
(a) who is either engaged or employed by the contractor or, where the
contractor is a partnership, is a partner in that partnership;
(b) whose name is registered in
(i) the Nursing and Midwifery Register,
(ii) the Register of Pharmaceutical Chemists maintained in pursuance
of section 2(1) of the Pharmacy Act 1954; or
(iii) the register maintained in pursuance of Articles 6 and 9 of the
Pharmacy (Northern Ireland) Order 1976,
and against whose name is recorded in the relevant register an annotation
signifying that the person is qualified to order drugs medicines and
appliances as a supplementary prescriber;
“system of clinical governance” means a framework through which the
Contractor endeavours continuously to improve the quality of its service
19
Standard General Medical Services Contract (12.03.04)
and safeguard high standards of care by creating an environment in which
clinical excellence can flourish;
“temporary opt out” in relation to the provision of an additional service
that is funded through the global sum, means the suspension of the
obligation under the Contract for the Contractor to provide that service for
a period of more than six months and less than twelve months and
includes an extension of a temporary opt out and “opt out temporarily”
and “opted out temporarily” shall be construed accordingly;
“temporary opt out notice” means an opt out notice to opt out temporarily;
“temporary resident” means a person accepted by the Contractor as a
temporary resident under clauses 177 to 180 and for whom the
Contractor’s responsibility has not been terminated in accordance with
those clauses;
“transferee out of hours services provider” means a person referred
to in clause 354 who has undertaken to carry out the obligations of
the Contractor during all or part of the out of hours period in
accordance with an out of hours arrangement
“Tribunal” has the meaning indicated in section 29 of the Act (the NHS
Tribunal);
“working day” means any day apart from Saturday, Sunday, Christmas
Day, New Year’s Day and any other public or local holiday.
20
Standard General Medical Services Contract (12.03.04)
1. In this Contract unless the context otherwise requires:
1.1. Defined terms and phrases appear in italics, except for the terms
“patient” and “Contract”;
1.2. Words denoting any gender include all genders and words denoting
the singular include the plural and vice versa.
1.3. Reference to any person may include a reference to any firm,
company or corporation.
1.4. Reference to “day”, “week”, “month” or “year” means a calendar
day, week, month or year, as appropriate
1.5. The headings in this Contract are inserted for convenience only and
do not affect the construction or interpretation of this Contract.
1.6. The schedules to this Contract are and shall be construed as being
part of this Contract.
1.7. Reference to any statute or statutory provision includes a reference
to that statute or statutory provision as from time to time amended,
extended, re-enacted or consolidated (whether before or after the
date of this Contract), and all statutory instruments or orders made
pursuant to it.
1.8. Where, pursuant to any order made under section 7 of the 2004 Act-
1.8.1. any matter or act that took place, or
21
Standard General Medical Services Contract (12.03.04)
1.8.2. any notice that was served ,
before the entry into force of the Contract is to be treated as if it took
place pursuant to the Contract, it shall be so treated and the Contract,
and obligations under the Contract, shall be interpreted consistently
with that Order.
1.9. Any obligation relating to the completion and submission of any
form that the Contractor is required to complete and submit to the
HB includes the obligation to complete and submit the form in such
a format or formats (electronic, paper or otherwise) as the HB may
specify.
1.10.
Any obligation on the Contractor to have systems, procedures
or controls includes the obligation effectively to operate them.
1.11.
Where this Contract imposes an obligation on the Contractor,
the Contractor must comply with it and must take all reasonable
steps to ensure that its personnel and contractors comply with it.
Similarly, where this Contract imposes an obligation on the HB, the
HB must comply with it and must take all reasonable steps to ensure
that its personnel and contractors (save for the Contractor) comply
with it.
2. Where there is any dispute as to the interpretation of a particular term in
the Contract, the parties shall, so far as is possible, interpret the provisions
of the Contract consistently with the European Convention on Human
Rights, EC law, the Regulations, any Order made under section 7 of the
2004 Act and any other relevant regulations made under the Act.
22
Standard General Medical Services Contract (12.03.04)
3. Where the parties have indicated in writing that a clause in the Contract is
reserved, that clause is not relevant and has no application to the
Contract3.
4. Where a particular clause is included in the Contract but is not relevant to
the Contractor because that clause relates to matters which do not apply to
the Contractor (for example, if the clause only applies to partnerships and
the Contractor is an individual medical practitioner), that clause is not
relevant and has no application to the Contract.
This provision has been included so that if, in relation to a particular contract, a particular
clause number or numbers are not relevant (for example, because that clause or those clauses
only need to be included in contracts with a partnership and the contractor concerned is an
individual medical practitioner) the words of that clause can be deleted and the word
‘reserved’ can be inserted next to that clause number: this is to avoid renumbering the clauses
or cross-references in the Contract.
3
23
Standard General Medical Services Contract (12.03.04)
PART 24
RELATIONSHIP BETWEEN THE PARTIES
5. The Contract is a contract for the provision of services. The Contractor is
an independent provider of services and is not an employee, partner or
agent of the HB. The Contractor must not represent or conduct its
activities so as to give the impression that it is the employee, partner or
agent of the HB.
6. The HB does not by entering into this Contract, and shall not as a result of
anything done by the Contractor in connection with the performance of
this Contract, incur any contractual liability to any other person.
7. This Contract does not create any right enforceable by any person not a
party to it.5
8. In complying with this Contract, in exercising its rights under the Contract
and in performing its obligations under the Contract, the Contractor must
act reasonably and in good faith.
9. In complying with this Contract, and in exercising its rights under the
Contract, the HB must act reasonably and in good faith and as a
responsible public body required to discharge its functions under the Act.
10. Clauses 8 and 9 above do not relieve either party from the requirement to
comply with the express provisions of this Contract and the parties are
subject to all such express provisions.
4
Except where indicated, Part 2 is not required by the Regulations, but is recommended.
24
Standard General Medical Services Contract (12.03.04)
11. The Contractor shall not give, sell, assign or otherwise dispose of the
benefit of any of its rights under this Contract, [save in accordance with
Schedule 1]6 [and subject to specific provision made in clauses 351 to 378]7.
The Contract does not prohibit the Contractor from delegating its
obligations arising under the Contract where such delegation is expressly
permitted by the Contract.
12. The HB may give, sell, assign or otherwise dispose of the benefit of its
rights under this Contract to another HB.
This clause is required by the Regulations (see paragraph 116 of Schedule 5).
The words indicated in square brackets only need to be included if the Contractor is a
partnership and Schedule 1 (partnerships) has therefore been utilised.
7 The words indicated in square brackets only need to be included if clauses 351 to 378 are to
be included in the Contract (see Part 14).
5
6
25
Standard General Medical Services Contract (12.03.04)
PART 3
NHS CONTRACT8
13. The Contractor has [not] elected to be regarded as a health service body for
the purposes of 17A(2) of the Act. Accordingly, this Contract is [not] an
NHS contract.9
If the Contractor has elected to be regarded as a health service body for the purposes of section
17A of the Act pursuant to regulation 10 of the Regulations, then the Contract must state that it
is an NHS contract: see regulation 12 of the Regulations.
9 Where the contract is an NHS contract, it is not enforceable in the courts but instead is subject
to the dispute resolution procedures set out in clauses 469 to 474 of the Contract and Part 7 of
Schedule 5 to the Regulations. Therefore, the Contract must specify whether or not the
Contractor has elected to be regarded as a health service body, and if it has, the Contractor must
indicate that the Contract is an NHS contract.
8
26
Standard General Medical Services Contract (12.03.04)
PART 4
COMMENCEMENT OF THE CONTRACT
14. This Contract shall commence on [date].10
DURATION OF THE CONTRACT
15. [Subject to clause 16]11 The Contract shall subsist until [insert date]/[it is
terminated in accordance with the terms of this Contract or the general
law.]12
16. [If the parties agree that the Contractor is going to provide services other
than essential services, additional services funded under the global sum or out
of hours services provided pursuant to regulation 30 or 31 of the Regulations,
(for example, enhanced services or additional services not funded under the
global sum) details in relation to the period for which each of those services
is to be provided should be inserted here: the period for which each of
such services will be provided is a matter for negotiation between the
parties]13
17. [
]
The parties must insert the date of commencement, which must be a date no earlier than 1
April 2004: see Regulation 28 of the Regulations.
11 The words in square brackets only need to be included if clause 16 et seq. are completed.
12 This clause is required by the Regulations: see Regulation 14 of the Regulations. The option for
the Contract to subsist until it is terminated in accordance with the terms of the Contract or
the general law must be included unless the HB is entering into a temporary contract for a
period not exceeding 12 months for the provision of services to the patients of the Contractor,
following the termination of a previous contract that that Contractor held with the HB. The
HB or the Contractor may, if it wishes to do so, invite the Area Medical Committee to
participate in the negotiations intending to lead to a temporary contract.
13 This clause needs to be adapted and completed as indicated – if it is not relevant because
there are no such services to be provided under the Contract, it should be deleted.
10
27
Standard General Medical Services Contract (12.03.04)
18. [
]
19. [
]
28
Standard General Medical Services Contract (12.03.04)
PART 514
WARRANTIES
20. Each of the parties warrants that it has power to enter into this Contract
and has obtained any necessary approvals to do so.
21. The Contractor warrants that:
21.1.
all information in writing provided to the HB in seeking to
become a party to this Contract was, when given, true and accurate
in all material respects, and in particular, that the Contractor
satisfied the conditions set out in regulations 4 and 5 the Regulations;
21.2.
no information has been omitted which would make the
information that was provided to the HB materially misleading or
inaccurate;
21.3.
no circumstances have arisen which materially affect the truth
and accuracy of such information;
21.4.
it is not aware as at the date of this Contract of anything within
its reasonable control which may or will materially adversely affect
its ability to fulfil its obligations under this Contract.
22. The HB warrants that:
22.1.
all information in writing which it provided to the Contractor
specifically to assist the Contractor to become a party to this
Contract was, when given, true and accurate in all material respects;
14
This Part is not required by the Regulations, but is recommended.
29
Standard General Medical Services Contract (12.03.04)
22.2.
no information has been omitted which would make the
information that was provided to the Contractor materially
misleading or inaccurate;
22.3.
no circumstances have arisen which materially affect the truth
and accuracy of such information.
23. The HB and the Contractor have relied on, and are entitled to rely on,
information provided by one party to the other in the course of
negotiating the Contract.
30
Standard General Medical Services Contract (12.03.04)
PART 6
LEVEL OF SKILL15
24. The Contractor shall carry out its obligations under the Contract with
reasonable skill and care .
PROVISION OF SERVICES16
Premises
25. The address of each of the premises to be used by the Contractor or any
sub-contractor for the provision of services under the Contract is as
follows: [
]17.
26. Subject to any plan which is included in the Contract pursuant to clause
27, the Contractor shall ensure that premises used for the provision of
services under the Contract shall be:
26.1.
suitable for the delivery of those services; and
26.2.
sufficient to meet the reasonable needs of the Contractor’s
patients.
27. Where, on the date on which the Contract was signed, the HB is not
satisfied that all or any of the premises specified in clause 25 met the
This clause is required by the Regulations (see paragraph 60 of Schedule 5).
Except where specifically indicated in a footnote, this whole section (Provision of Services)
is required by the Regulations (see regulation 18(1)(b), (2) and (3), 25 and Part 1 of Schedule 5).
17 All relevant addresses from which services under the Contract will be provided by the
Contractor or any sub-contractor must be included here. It does not include the homes of
patients or any other premises where services are provided on an emergency basis. This
clause is required by regulation 18(1)(b) of the Regulations, together with regulation 18(2).
15
16
31
Standard General Medical Services Contract (12.03.04)
requirements set out in clause 26, and consequently the HB and the
Contractor have together drawn up a plan (contained in Schedule 5 to this
Contract) which specifies-
27.1.
the steps to be taken by the Contractor to bring the premises up
to the relevant standard;
27.2.
any financial support that is available from the HB; and
27.3.
the timescale in which such steps will be taken18.
28. The Contractor shall comply with the plan specified in clause 27 and
contained in Schedule 5 to this Contract as regards the steps to be taken by
the Contractor to meet the requirements in clause 26 and the timescale in
which those steps will be taken.
Attendance at practice premises
29. The Contractor shall take reasonable steps to ensure that any patient who
has not previously made an appointment and attends at the practice
premises during the normal hours for essential services is provided with such
services by an appropriate health care professional during that surgery
period except where:
29.1.
it is more appropriate for the patient to be referred elsewhere for
services under the Act; or
Clause 27, clause 28 and Schedule 5 need only be included in the Contract if the HB is not
satisfied that any or all of the premises at which services are to be provided meet the
standards set out in clause 26 at the date the Contract is signed. If the premises do meet the
standards, these clauses can be deleted.
18
32
Standard General Medical Services Contract (12.03.04)
29.2.
the patient is then offered an appointment to attend again
within a time which is reasonable having regard to all the
circumstances and his health would not thereby be jeopardised.
Attendance outside practice premises
30. In the case of a patient whose medical condition is such that in the
reasonable opinion of the Contractor attendance on the patient is required
and it would be inappropriate for the patient to attend at the practice
premises, the Contractor shall provide services to that patient at whichever
in its judgement is the most appropriate of the following places:
30.1.
the place recorded in the patient’s medical records as being his
last home address;
30.2.
such other place as the Contractor has informed the patient and
the HB is the place where it has agreed to visit and treat the patient;
30.3.
some other place in the Contractor’s practice area.
31. Nothing in this clause or clause 30 prevents the Contractor from:
31.1.
arranging for the referral of a patient without first seeing the
patient, in a case where the medical condition of that patient makes
that course of action appropriate; or
31.2.
visiting the patient in circumstances where this paragraph does
not place it under an obligation to do so.
Newly registered patients
33
Standard General Medical Services Contract (12.03.04)
32. Where a patient has been accepted on the Contractor’s list of patients under
clauses 171 to 176 or assigned to that list by the HB, the Contractor shall, in
addition and without prejudice to its other obligations in respect of that
patient under the Contract, invite the patient to participate in a
consultation either at its practice premises or, if the medical condition of the
patient so warrants, at one of the places referred to in clause 30. Such an
invitation shall be issued within six months of the date of the acceptance of
the patient on, or their assignment to, the Contractor’s list of patients.
33. Where a patient (or, in the case of a patient who is a child, where
appropriate, his parent) agrees to participate in a consultation referred to in
clause 32 above, the Contractor shall, in the course of that consultation,
make such inquiries and undertake such examinations as appear to it to be
appropriate in all the circumstances.
Patients not seen within 3 years
34. Where a registered patient who:
34.1.
has attained the age of 16 years but has not attained the age of
75 years; and
34.2.
has attended neither a consultation with, nor a clinic provided
by, the Contractor within the period of three years prior to the date
of his request,
requests a consultation the Contractor shall, in addition and without
prejudice to its other obligations in respect of that patient under the
Contract provide such a consultation.
34
Standard General Medical Services Contract (12.03.04)
35. Where the Contractor provides a consultation referred to in clause 34, the
Contractor shall, in the course of that consultation, make such inquiries
and undertake such examinations as appear to it to be appropriate in all
the circumstances.
Patients aged 75 years and over
36. Where a registered patient who-
36.1.
has attained the age of 75 years; and
36.2.
has not participated in a consultation under this clause within
the period of twelve months prior to the date of his request,
requests a consultation, the Contractor shall, in addition and without
prejudice to its other obligations in respect of that patient under the
Contract, provide such a consultation in the course of which it shall make
such inquiries and undertake such examinations as appear to it to be
appropriate in all the circumstances.
37. A consultation under clause 36 shall take place in the home of the patient
where, in the reasonable opinion of the Contractor, it would be
inappropriate, as a result of the patient’s medical condition, for him to
attend at the practice premises.
Clinical reports
38. Where the Contractor provides any clinical services, other than under a
private arrangement, to a patient who is not on its list of patients, it shall,
as soon as reasonably practicable, provide a clinical report relating to the
consultation, and any treatment provided, to the HB. The HB shall send
35
Standard General Medical Services Contract (12.03.04)
any report received to the person with whom the patient is registered for
the provision of essential services or their equivalent or if that person is not
known to the HB, the Health Board in whose area the patient is resident.
Storage of vaccines
39. The Contractor shall ensure that-
39.1.
all vaccines are stored in accordance with the manufacturer’s
instructions
39.2.
all refrigerators in which vaccines are stored have a
maximum/minimum thermometer and that readings are taken on
all working days.
Infection control
40. The Contractor shall ensure that it has appropriate arrangements for
infection control and decontamination.
Duty of co-operation in relation to additional, enhanced and out of hours
services19
Although not every aspect of clauses 41 to 44 will be relevant to every Contractor, these
clauses should be left in every GMS Contract as in many cases, a Contractor will not be
providing each additional service, each enhanced service and out of hours services: these clauses
have been drafted so that they can be left in the contract even if that were to be the case.
These clauses are required by paragraph 12 of Schedule 5 to the Regulations.
19
36
Standard General Medical Services Contract (12.03.04)
41. If the Contractor is not, pursuant to the Contract, providing to its registered
patients or to persons whom it has accepted as temporary residents—
41.1.
a particular additional service;
41.2.
a particular enhanced service; or
41.3.
out of hours services, either at all or in respect of some periods or
some services,
the Contractor shall comply with the requirements specified in clause 42.
42. The requirements referred to in clause 41 are that the Contractor shall—
42.1.
co-operate, insofar as is reasonable, with any person responsible
for the provision of that service or those services;
42.2.
comply in core hours with any reasonable request for information
from such a person or from the HB relating to the provision of that
service or those services; and
42.3.
in the case of out of hours services, take reasonable steps to ensure
that any patient who contacts the practice premises during the out of
hours period is provided with information about how to obtain
services during that period.
43. Nothing in clauses 41 and 42 shall require the Contractor (if it is not
providing out of hours services under the Contract) to make itself available
during the out of hours period.
44. If the Contractor is to cease to be required to provide to its patients—
37
Standard General Medical Services Contract (12.03.04)
44.1.
a particular additional service;
44.2.
a particular enhanced service; or
44.3.
out of hours services, either at all or in respect of some periods or
some services;
it shall comply with any reasonable request for information relating to the
provision of that service or those services made by the HB or by any person
with whom the Board intends to enter into a contract for the provision of such
services.
38
Standard General Medical Services Contract (12.03.04)
PART 720
ESSENTIAL SERVICES
45. The Contractor must provide the services described in clauses 46 to 51
(essential services) at such times within core hours as are appropriate to
meet the reasonable needs of its patients and to have in place
arrangements for its patients to access such services throughout the core
hours in case of emergency21.
46. The Contractor must provide-
46.1.
services required for the management of the Contractor’s
registered patients and temporary residents who are, or believe
themselves to be-
46.1.1. ill with conditions from which recovery is generally expected;
46.1.2. terminally ill; or
46.1.3. suffering from chronic disease
delivered in the manner determined by the practice in discussion with
the patient;
46.2.
appropriate ongoing treatment and care to all registered patients
and temporary residents taking account of their specific needs
including-
This Part is required by the Regulations (see regulation 15). Every GMS Contract must
require the Contractor to provide essential services..
21 This clause is also required by regulation 20 of the Regulations.
20
39
Standard General Medical Services Contract (12.03.04)
46.2.1. the provision of advice in connection with the patient’s health,
including relevant health promotion advice; and
46.2.2. the referral of the patient for other services under the Act; and
46.3.
primary medical services required in core hours for the
immediately necessary treatment of any person to whom the
Contractor has been requested to provide treatment owing to an
accident or emergency at any place in its practice area.
47. For the purposes of clause 46.1, “management” includes-
47.1.
offering a consultation and, where appropriate, physical
examination for the purpose of identifying the need, if any, for
treatment or further investigation; and
47.2.
the making available of such treatment or further investigation
as is necessary and appropriate, including the referral of the patient
for other services under the Act and liaison with other health care
professionals involved in the patient’s treatment and care.
48. For the purposes of clause 46.3, “emergency” includes any medical
emergency whether or not related to services provided under the
Contract.
49. The Contractor must provide primary medical services required in core
hours for the immediately necessary treatment of any person falling within
clause 50 who requests such treatment, for the period specified in clause
51.
50. A person falls within this clause if he is a person-
40
Standard General Medical Services Contract (12.03.04)
50.1.
whose application for inclusion in the Contractor’s list of
patients has been refused in accordance with clauses 181 to 184 and
who is not registered with another provider of essential services (or
their equivalent) in the area of the HB;
50.2.
whose application for acceptance as a temporary resident has been
rejected under clauses 181 to 184; or
50.3.
who is present in the Contractor’s practice area for less than 24
hours.
51. The period referred to in clause 49 is-
51.1.
in the case of clause 50.1 14 days beginning with the date on
which that person’s application was refused or until that person has
been registered elsewhere for the provision of essential services (or
their equivalent), whichever occurs first;
51.2.
in the case of clause 50.2, 14 days beginning with the date on
which that person’s application was rejected or until that person has
been subsequently accepted elsewhere as a temporary resident,
whichever occurs first; and
51.3.
in the case of clause 50.3, 24 hours or such shorter period as the
person is present in the Contractor’s practice area.
41
Standard General Medical Services Contract (12.03.04)
PART 822
ADDITIONAL SERVICES
52. In relation to each additional service it provides, the Contractor shall
provide such facilities and equipment as are necessary to enable it
properly to perform that service.
53. Where an additional service is to be funded under the global sum, the
Contractor must provide that additional service at such times, within core
hours, as are appropriate to meet the reasonable needs of its patients. The
Contractor must also have in place arrangements for its patients to access
such services throughout the core hours in case of emergency.
54. The Contractor shall provide the additional services23 set out in clause 55 to-
This Part only needs to be included in the Contract where the Contractor is to provide any
one or more of the additional services. Where the contract is with an individual medical practitioner who, on 31st March 2004, was providing
services under section 19 of the Act;
 a partnership at least one member of which was, on 31 st March 2004, a
medical practitioner providing services under section 19 of the Act; or
 a company in which one or more of the shareholders was, on 31 st March 2004,
a medical practitioner providing services under section 19 of the Act
and services are to be provided under the Contract from 1 April 2004, the contract must
provide for the Contractor to provide in core hours to its registered patients and persons
accepted by it as temporary residents such of the additional services as are equivalent to the
services which that medical practitioner or practitioners was or were providing to his or their
patients on the date that the Contract is entered exceptt to the extent that: the provision of any of those services by that medical practitioner or
practitioners was due to come to an end on or before the date on which
services are required to start being provided under the Contract, or
 prior to the signing of the Contract, the PCT has accepted in writing a written
request from the Contractor that the Contract should not require it to provide
all or any of those additional services (see regulation 29 of the Regulations).
In any other circumstances, it is for the Contractor and the PCT to negotiate which additional
services will be provided by the Contractor. If the Contractor is providing any one or more
additional services under the Contract (whether or not pursuant to regulation 29), then the
clauses relating to that particular additional service are required to be inserted into the
Contract: clause 52 must be included where any one or more additional services is being
provided by the Contractor under the Contract. This reflects the requirements of regulation
16 and Schedule 1 to the Regulations
22
42
Standard General Medical Services Contract (12.03.04)
54.1.
its registered patients; and
54.2.
persons accepted by it as temporary residents;
55. The Contractor shall provide to the patients specified in clause 54-
55.1.
[cervical screening services];
55.2.
[contraceptive services];
55.3.
[vaccinations and immunisations];
55.4.
[childhood vaccinations and immunisations];
55.5.
[child health surveillance services];
55.6.
[maternity medical services];
55.7.
[minor surgery].
56. The Contractor shall provide the additional services24 set out in [ ] to [
]25
Delete from the list at clause 55 any of the additional services that the Contractor is not going
to be providing under the Contract.
24 Delete from the list at clause 55 any of the additional services that the Contractor is not going
to be providing under the Contract.
25 Clauses 56 and 57 only need to be included if the parties agree that the Contractor will
provide additional services that are not funded by the global sum. If the parties do so agree,
details need to be inserted at clause 56 of the patients to whom such services will be
provided, and where particular additional services specified in clause 57 are to be provided to
particular patients (for example maternity medical services is to be provided to one group of
patients and minor surgery is to be provided to a different group of patients), the spaces in
square brackets at clause 56 should be completed to make it clear which additional services
included at clause 57 are to be provided to which patients: any additional services that the
23
43
Standard General Medical Services Contract (12.03.04)
57. The Contractor shall provide to the patients specified in clause 56-
57.1.
[cervical screening services];
57.2.
[contraceptive services];
57.3.
[vaccinations and immunisations];
57.4.
[childhood vaccinations and immunisations];
57.5.
[child health surveillance services];
57.6.
[maternity medical services];
57.7.
[minor surgery].
58. [
]
59. [
]
60. [
]
61. [
]
62. [
]
63. [
]
64. [
]
Contractor will not be providing to patients specified in clause 56 need to be deleted from
clause 57.
44
Standard General Medical Services Contract (12.03.04)
65. [
]
66. [
]
Cervical screening26
67. The Contractor shall-
67.1.
provide the services described in clause 68; and
67.2.
make such records as are referred to in clause 69.
68. The services referred to in clause 67 are-
68.1.
the provision of any necessary information and advice to assist
women identified by the HB as recommended nationally for a
cervical screening test in making an informed decision as to
participation in the NHS Scotland Cervical Screening Programme;
68.2.
the performance of cervical screening tests on women who have
agreed to participate in that Programme;
68.3.
arranging for women to be informed of the results of the test;
45
Standard General Medical Services Contract (12.03.04)
68.4.
ensuring that test results are followed up appropriately.
69. The records referred to in clause 67 are an accurate record of the carrying
out of a cervical screening test, the address where it was done, the result of
the test and any clinical follow up requirements.
Contraceptive services27
70. The Contractor shall make available the following services to all of its
patients who request such services:
70.1.
the giving of advice about the full range of contraceptive
methods;
70.2.
where appropriate, the medical examination of patients seeking
such advice;
70.3.
the
the treatment of such patients for contraceptive purposes and
prescribing
of
contraceptive
substances
and
appliances
(excluding the fitting and implanting of intrauterine devices and
implants);
70.4.
the giving of advice about emergency contraception and where
appropriate, the supplying or prescribing of emergency hormonal
contraception or, where the Contractor has a conscientious objection
to emergency contraception, prompt referral to another provider of
primary medical services who does not have such conscientious
Clauses 67 to 69 are required by the Regulations only where the Contract includes the
provision of cervical screening services. If the Contractor is not providing cervical screening
services, these clauses should be deleted.
27 Clause 70 is required by the Regulations only where the Contract includes the provision of
contraceptive services. If the Contractor is not providing contraceptive services, this clause should
be deleted.
26
46
Standard General Medical Services Contract (12.03.04)
objections;
70.5.
the provision of advice and referral in cases of unplanned or
unwanted pregnancy, including advice about the availability of free
pregnancy testing in the practice area and, where appropriate, where
the Contractor has a conscientious objection to the termination of
pregnancy, prompt referral to another provider or primary medical
services who does not have such conscientious objections;
70.6.
the giving of initial advice about sexual health promotion and
sexually transmitted infections; and
70.7.
the referral as necessary for specialist sexual health services,
including tests for sexually transmitted infections.
Vaccinations and immunisations28
71. The Contractor shall-
71.1.
offer to provide to patients all vaccinations and immunisations
(excluding childhood vaccinations and immunisations) of a type and in
the circumstances for which a fee was provided for under the 200304 Statement of Fees and Allowances made under regulation 35 of
the National Health Service (General Medical Services) (Scotland)
Regulations
71.2.
1995
other
than
influenza
vaccination.;
provide appropriate information and advice to patients about
such vaccinations and immunisations;
Clauses 71 and 72 are required by the Regulations only where the Contract includes the
provision of vaccinations and immunisations. If the Contractor is not providing vaccinations and
immunisations, these clauses should be deleted.
28
47
Standard General Medical Services Contract (12.03.04)
71.3.
record in the patient’s record kept in accordance with clauses
379 to 387 any refusal of the offer referred to in clause 71.1;
71.4.
where the offer is accepted, administer the vaccinations and
immunisations and include in the patient’s record kept in
accordance with clause 379 to 387
71.4.1. the patient’s consent to the vaccination or immunisation or the
name of the person who gave consent to the vaccination or
immunisation and his relationship to the patient;
71.4.2. the batch numbers, expiry date and title of the vaccine;
71.4.3. the date of administration;
71.4.4. in a case where two vaccines are administered in close
succession, the route of administration and the injection site of
each vaccine;
71.4.5. any contraindications to the vaccination or immunisation; and
71.4.6. any adverse reactions to the vaccination or immunisation.
72. The Contractor shall ensure that all staff involved in administering
vaccines are trained in the recognition and initial treatment of anaphylaxis
48
Standard General Medical Services Contract (12.03.04)
Childhood vaccinations and immunisations29
73. The Contractor shall-
73.1.
offer to provide to children all vaccinations and immunisations
of a type and in the circumstances for which a fee was provided for
under the 2003-04 Statement of Fees and Allowances made under
regulation 35 of the National Health Service (General Medical
Services) (Scotland) Regulations 1995;
73.2.
provide appropriate information and advice to patients and,
where appropriate, their parents about such vaccinations and
immunisations;
73.3.
record in the patient’s record kept in accordance with clause 379
to 387 any refusal of the offer referred to in clause 73.1;
73.4.
where the offer is accepted, administer the vaccinations and
immunisations and include in the patient’s record kept in
accordance with clauses 379 to 387-
73.4.1. the name of the person who gave consent to the vaccination or
immunisation and his relationship to the patient;
73.4.2. the batch numbers, expiry date and title of the vaccine;
73.4.3. the date of administration;
Clauses 73 to 74 are required by the Regulations only where the Contract includes the
provision of childhood vaccinations and immunisations. If the Contractor is not providing
childhood vaccinations and immunisations, these clauses should be deleted.
29
49
Standard General Medical Services Contract (12.03.04)
73.4.4. in a case where two vaccines are administered in close
succession, the route of administration and the injection site of
each vaccine;
73.4.5. any contraindications to the vaccination or immunisation; and
73.4.6. any adverse reactions to the vaccination or immunisation.
74. The Contractor shall ensure that all staff involved in administering
vaccines are trained in the recognition and initial treatment of anaphylaxis
Child health surveillance30
75. The Contractor shall, in respect of any child under the age of five for
whom it has responsibility under the Contract-
75.1.
provide the services described in clause 76, other than any
examination so described which the parent refuses to allow the child
to undergo, until the date upon which the child attains the age of
five years; and
75.2.
maintain such records as are specified in clause 77.
76. The services referred to in clause 75.1 are-
76.1.
the monitoring-
Clauses 75 to 77 are required by the Regulations only where the Contract includes the
provision of child health surveillance services. If the Contractor is not providing child health
surveillance services, these clauses should be deleted.
30
50
Standard General Medical Services Contract (12.03.04)
76.1.1. by the consideration of any information concerning the child
received by or on behalf of the Contractor, and
76.1.2. on any occasion when the child is examined or observed by or
on behalf of the Contractor (whether pursuant to clause 76.2 or
otherwise),
of the health, well-being and physical, mental and social development
(all of which characteristics are referred to in clauses 76 to 78 as
“development”) of the child while under the age of 5 years with a view
to detecting any deviations from normal development;
76.2.
the examination of the child at a frequency that has been agreed
with the HB in accordance with the nationally agreed evidence
based programme set out in the fourth edition of “Health for all
Children
(Hall
and
Elliman,
2003
ISBN
0-19-85188-X).
77. The records referred to in clause 75.2 are an accurate record of-
77.1.
the development of the child while under the age of 5 years,
compiled as soon as is reasonably practicable following the first
examination of that child and, where appropriate, amended
following each subsequent examination; and
77.2.
the responses (if any) to offers made to the child’s parent for the
child to undergo any examination referred to in clause 76.2.
51
Standard General Medical Services Contract (12.03.04)
Maternity medical services31
78. The Contractor shall provide -
78.1.
to female patients who have been diagnosed as pregnant all
necessary maternity medical services throughout the antenatal
period;
78.2.
to female patients and their babies all necessary maternity
medical services throughout the post natal period other than
neonatal checks;
78.3.
all necessary maternity medical services to female patients
whose pregnancy has terminated as a result of miscarriage or
abortion or, where the Contractor has a conscientious objection to
the termination of pregnancy, prompt referral to another provider of
primary medical services, who does not have such conscientious
objections.
79. In clause 78, “ante-natal period” means the period from the start of the
pregnancy to the onset of labour, “maternity medical services” , in relation
to female patients (other than babies) means all primary medical services
relating to pregnancy, excluding intra partum care, and in relation to
babies, any primary medical services necessary in their first 14 days of life,
and “post natal period” means the period starting from the conclusion of
delivery of the baby or the patient’s discharge from secondary care
services, whichever is the later, and ending on the fourteenth day after the
birth.
Clauses 78 to 79 are required by the Regulations only where the Contract includes the
provision of maternity medical services. If the Contractor is not providing maternity medical
31
52
Standard General Medical Services Contract (12.03.04)
Minor surgery32
80. The Contractor shall make available to patients where appropriate
curettage and cautery and, in relation to warts, verrucae and other skin
lesions, cryocautery.
81. The Contractor shall ensure that its record of any treatment provided
pursuant to clause 80 includes the consent of the patient to that treatment.
services, these clauses should be deleted.
32 Clauses 80 and 81 are required by the Regulations only where the Contract includes the
provision of minor surgery. If the Contractor is not providing minor surgery, these clauses
should be deleted.
53
Standard General Medical Services Contract (12.03.04)
PART 9
OUT OF HOURS SERVICES
82. [Subject to clause 83, the Contractor shall provide-
82.1. the services which must be provided in core hours pursuant to
clauses 45 to 51; and
82.2. such additional services (if any) as are included in the Contract
pursuant to clause 55
during the out of hours period33].
83. The Contractor shall only be required to provide the services specified in
clause 82 during the out of hours period to a patient if, in the reasonable
opinion of the Contractor in the light of the patient’s medical condition, it
would not be reasonable in all the circumstances for the patient to wait for
the services required until the next time at which he could obtain such
services during core hours34.
84. From 1st January 2005, the Contractor must, in the provision of out of hours
services, meet the national quality standards set out from time to time in
guidance which has been issued to Health Boards by NHS Quality
Improvement Scotland and notified in writing to the contractor by the HB.
85. If the Contractor is required to provide out of hours services under the
Contract pursuant to regulation 31 of the Regulations to the patients of an
This clause is mandatory only if out of hours services are being provided pursuant to
regulation 30 or 31 of the Regulations: if out of hours services are included in the Contract other
than by virtue of regulation 30 or 31, details of what services are to be provided by the
Contractor during the out of hours period should be included here instead, and the provision
can be re-drafted depending on what is agreed between the parties.
33
54
Standard General Medical Services Contract (12.03.04)
exempt contractor it shall provide such services, and continue to provide
such services until-
85.1. it has opted out of the provision of out of hours services in accordance
with Part 10 of this Contract;
85.2. the HB and, where applicable, the Health Board that holds a contract
with the contractor for whom out of hours services are being provided
by the Contractor under the Contract, has or have agreed in writing
that the Contractor need no longer provide some or all of those
services to some or all of those patients35.
86.
[
]
87.
[
]
Note A contractor is required to provide out of hours services under the Contract if it falls
within the categories specified in regulations 30 to 31 of the Regulations: otherwise it is a
matter for negotiation between the parties. This means that the Contractor must provide out
of hours services under the Contract in the following circumstances:1. (regulation 30) if, under the Contract, the Contractor will be providing any services
before 1st January 2005 (whether or not services will be provided after that date), the
Contract must provide for out of hours services to be provided to patients by the
Contractor unless:a) the HB has accepted in writing, prior to the signing of the Contract, a written
request from the Contractor that the Contract should not require the Contractor
to make such provision; or
b) the Contract is, at the date on which it is signed, with a medical practitioner who is or was, on 31st March 2004 relieved of
responsibility for providing services to his patients under paragraph
17 (2) of Schedule 1 to the National Health Service (General Medical
Services)(Scotland) Regulations 1995;
 a partnership in which all of the partners who are general medical
practitioners are, or were on 31st March 2004 relieved of responsibility
for providing services to their patients under that paragraph on that
date;
 a company in which all of the general medical practitioners who own
shares in that company are, or were on 31 st March 2004 relieved of
This clause is required whenever out of hours services will be provided, whether pursuant to
regulation 30 or 31 of the Regulations or not.
35 This clause is only required if the Contractor is providing out of hours services pursuant to
regulation 31 of the Regulations. Otherwise this clause should be deleted.
34
55
Standard General Medical Services Contract (12.03.04)
2.
3.
responsibility for providing services to their patients under that
paragraph on that date
c) the Contractor opts out of the provision of out of hours services pursuant to the
Contract (which will not affect the need to include the provision of out of hours
services in the Contract at the point the Contract is entered into); or
d) the Contract has been otherwise varied to exclude a requirement to make such
provision (this will not be relevant at the point where the Contract is being
entered into because there will not be any such variation until there is a contract
to vary); and
(regulation 31) if the Contract is with any of the persons specified in a) to c) below,
the Contract must require the Contractor to continue providing out of hours services to
patients of an exempt contractor where the Contractor isa) an individual medical practitioner who is, or was on 31 st March 2004, responsible
for providing services during all or part of the out of hours period to the patients
of a medical practitioner who meets the requirements set out in paragraph 3
below(“exempt contractor”);
b) a partnership at least one of member of which is, or was on 31 st March 2004, a
medical practitioner responsible for providing such services; or
c) a company in which one or more of the shareholders is, or was, on 31st March
2004, a medical practitioner responsible for providing such services
and the Contractor must continue to provide such services until it has opted out of
the provision of out of hours services in accordance with Part 10 of the Contract, or the
HB (or if it is different, the Health Board with whom the exempt contractor holds its
contract)) has or have agreed in writing that the Contractor need no longer provide
some or all of those services to some or all of those patients.
the requirements referred to in 2.a) are thata) the medical practitioner was relieved of responsibility for providing services to
his patients under paragraph 17 (2) of Schedule 1 to the National Health Service
(General Medical Services)(Scotland) Regulations 1995; and
b) hea. has entered or intends to enter into a contract which does not include out
of hours services pursuant to paragraph 1(b) above,
b. is one of two or more individuals practising in partnership who have
entered or intend to enter into a contract which does not includes out of
hours services pursuant to paragraph 1(b) above;
c. is the owner of shares in a company which has entered or intends to
enter into a contract which does not include out of hours services pursuant
to paragraph 1(b) above.
56
Standard General Medical Services Contract (12.03.04)
PART 10
OPT OUTS OF ADDITIONAL AND OUT OF HOURS SERVICES36
Opt outs of additional services: general
88. Where the Contractor wishes to opt out permanently or opt out temporarily of
the provision of one or more additional services (referred to in clauses 89 to 128
below as “additional service”), the Contractor shall give to the HB in writing a
preliminary opt out notice which shall state the reasons for wishing to opt out.
89. As soon as is reasonably practicable and in any event within the period of
7 days beginning with the receipt of the preliminary opt out notice by the HB,
the HB shall enter into discussions with the Contractor concerning the
support which the HB may give the Contractor, or concerning other changes
which the HB or the Contractor may make, which would enable the
Contractor to continue to provide the additional service. The HB and the
contractor shall use reasonable endeavours to achieve this aim.
90. The discussions referred to in clause 89 shall be completed within the
period of 10 days beginning with the date of the receipt of the preliminary opt
out notice by the HB or as soon as reasonably practicable thereafter.
If,
following the discussions, the Contractor still wishes to opt out of the
provision of the additional service, it shall send an opt out notice to the HB.
These provisions are required by the Regulations in certain circumstances (see regulation 17
and Schedule 2): if the contract provides for the Contractor to provide an additional service that is to be
funded through the global sum, clauses 88 to 128 are required;
 if the Contract is entered into before 1st October 2004 and it provides for the
Contractor to provide out of hours services pursuant to regulation 29 or 30 of the
Regulations, clauses 129 to 152 are required;
 if the Contract is entered into on or after 1st October 2004 and the Contract provides
for the Contractor to provide out of hours services pursuant to regulation 29 or 30 of
the Regulations, clauses 129 to 136 are required.
If any of the provisions relating to opt outs of additional and out of hours services are included,
clauses 153 to 155 are required.
36
57
Standard General Medical Services Contract (12.03.04)
91. An opt out notice shall specify-
91.1 the additional service concerned;
91.2 whether the Contractor wishes to opt out permanently or opt out
temporarily;
91.3 the reasons for wishing to opt out;
91.4
the date from which the Contractor would like the opt out to
commence, which must in the case of a temporary opt out be at least 14 days
after the date of service of the opt out notice, and in the case of a permanent opt
out must be the day either 3 or 6 months after the date of service of the opt out
notice; and
91.5
in the case of a temporary opt out, the desired duration of the opt out.
92. Where the Contractor has given two previous temporary opt out notices
within the period of three years ending with the date of the service of the
latest opt out notice (whether or not the same additional service is concerned),
the latest opt out notice shall be treated as a permanent opt out notice even if the
opt out notice says that it wishes to opt out temporarily.
93. The Contractor may not serve a temporary opt out notice prior to 1 April
2004.
Temporary opt outs and permanent opt outs following temporary opt outs
94. Clauses 95 to 109 apply following the giving of a temporary opt out notice.
58
Standard General Medical Services Contract (12.03.04)
95. As soon as is reasonably practicable and in any event within the period of
7 days beginning with the date of receipt of a temporary opt out notice under
clause 90, the HB shall-
95.1 approve the opt out notice and specify in accordance with clauses 97 and
98 the date on which the temporary opt out is to commence and the date that it
is to come to an end (“the end date”); or
95.2 reject the opt out notice in accordance with clause 96,
and shall notify the Contractor of its decision as soon as possible, giving
reasons for its decision.
96
The HB may reject the opt out notice on the ground that the Contractor-
96.1
is providing additional services to patients other than its own registered
patients, or enhanced services, or
96.2
has no reasonable need to opt out temporarily having regard to its ability
to deliver the additional service.
97
The date specified by the HB for the commencement of the temporary
opt out shall wherever reasonably practicable be the date requested by the
Contractor in its opt out notice.
98
Before determining the end date, the HB shall make reasonable efforts
to reach agreement with the Contractor.
99
Where the HB approves an opt out notice, the Contractor’s obligation to
provide the additional service specified in the notice shall be suspended from
59
Standard General Medical Services Contract (12.03.04)
the date specified by the HB in its decision under clause 95 and shall remain
suspended until the end date unless-
99.1
the Contractor and the HB agree an earlier date in writing, in which
case the suspension shall come to an end on the earlier date agreed;
99.2
the HB specifies a later date under clause 99.4 in which case the
suspension shall end on the later date specified;
99.3
clause 103 applies, and the Contractor refers the matter to the NHS
dispute resolution procedure (or, where applicable in the case of a non-NHS
contract , commences court proceedings) in which case the suspension shall
end-
99.3.1 where the outcome of the decision is to uphold the decision of
the HB, on the day after the date of the decision of the adjudicator or,
as the case may be, the court;
99.3.2 where the outcome of the dispute is to overturn the decision of
the HB, 28 days after the decision of the adjudicator or, as the case may
be, the court, or
99.3.3 where the Contractor ceases to pursue the NHS dispute resolution
procedure or, as the case may be court proceedings, on the day after the
date that the Contractor withdraws its claim or the procedure is or
proceedings are otherwise terminated by the adjudicator or the court.
99.4
Clause 103 applies and-
60
Standard General Medical Services Contract (12.03.04)
99.4.1 the HB refuses the Contractor’s request for a permanent opt out
within the period of 28 days ending with the end date, in which case
the suspension shall come to an end 28 days after the end date;
99.4.2 the HB refuses the Contractor’s request for a permanent opt out
after the end date, in which case the suspension shall come to an end
28 days after the date of service of the notice; or
99.4.3 the HB notifies the Contractor after the end date that the
assessment panel has not approved its proposed decision to refuse the
Contractor’s request to opt out permanently under clause 106 after the
end date, in which case the suspension shall come to an end 28 days
after the date of service of the notice.
100
Before the end date, the HB may, in exceptional circumstances and
with the agreement of the Contractor, notify the Contractor in writing of a
later date on which the temporary opt out is to come to an end, being a date no
more than six months later than the end date.
101
Where the HB considers that-
101.1 the Contractor will be unable to satisfactorily provide the additional
service at the end of the temporary opt out; and
101.2 it would not be appropriate to exercise its discretion under clause 99.4
to specify a later date on which the temporary opt out is to come to an end or
the Contractor does not agree to a later date
the HB may notify the Contractor in writing at least 28 days before the end
date that a permanent opt out shall follow a temporary opt out.
61
Standard General Medical Services Contract (12.03.04)
102
Where the HB notifies the Contractor under clause 101 that the
permanent opt out shall follow a temporary opt out, the permanent opt out shall
take effect immediately after the end of the temporary opt out.
103
Where the Contractor has opted out temporarily, the Contractor may at
least three months prior to the end date notify the HB in writing that it wishes
to opt out permanently of the additional service in question.
104
Where the Contractor has notified the HB under clause 103 that it
wishes to opt out permanently, the temporary opt out shall be followed by a
permanent opt out beginning on the day after the end date unless the HB
refuses the Contractor’s request to opt out permanently by giving a notice in
writing to the Contractor to this effect.
105
The HB may only give a notice under clause 104 with the approval of
the assessment panel. The HB must ensure that an assessment panel is appointed
by another Health Board as soons as is practicable to consider and determine
whether or not to approve the HB’s proposed decision to refuse a permanent
opt out and shall provide the assessment panel with such information as the
assessment panel may reasonable require to enable it to reach a determination.
Where the HB seeks the approval of the assessment panel to a proposed
decision to refuse a permanent opt out under this clause, it shall notify the
Contractor of having done so.
106
If the assessment panel has not reached a decision as to whether or not to
approve the HB’s proposed decision to refuse a permanent opt out before the
end date, the Contractor’s obligation to provide the additional service shall
remain suspended until the date specified in clause 99.4.2 or 99.4.3 (whichever
is applicable).
62
Standard General Medical Services Contract (12.03.04)
107.
Where after the end date the assessment panel notifies the HB that it
does not approve the HB’s proposed decision to refuse a permanent opt out, the
HB shall notify the Contractor in writing of this fact as soon as is reasonably
practicable.
108.
A temporary opt out or permanent opt out commences, and a temporary opt
out ends at 08.00 on the relevant day unless-
108.1 the day is not a working day in which case the opt out shall take effect
on the next working day at 08.00; or
108.2 the HB and the Contractor agree a different day or time.
109.
Any decision or determination by the assessment panel for the
purposes of clauses 94 to 98 may be reached by a majority.
Permanent opt outs
110
In clauses 111 to 128-
“A Day” is the day specified by the Contractor in its permanent opt out
notice to the HB for the commencement of the permanent opt out;
“B Day” is the day six months after the date of service of the permanent opt
out notice; and
“C Day” is the day nine months after the date of service of the permanent
opt out notice.
111
As soon as is reasonably practicable and in any event within the period
of 28 days beginning with the date of receipt of a permanent opt out notice
63
Standard General Medical Services Contract (12.03.04)
under clause 90 (or temporary opt out notice which is treated as a permanent opt
out notice under clause 92), the HB shall-
111.1
approve the opt out notice; or
111.2
reject the opt out notice in accordance with clause 112,
and shall notify the Contractor of its decision as soon as possible,
including reasons for its decision where its decision is to reject the opt out
notice.
112
A HB may reject the opt out notice on the ground that the Contractor is
providing an additional service to patients other than its registered patients or
enhanced services.
113
The Contractor may not withdraw an opt out notice once it has been
approved by the HB in accordance with clause 111.1 without the HB’s
agreement.
114
If the HB approves the opt out notice under clause 111.1, it shall use its
reasonable endeavours to make arrangements for the Contractor’s registered
patients to receive the additional service from an alternative provider from A
day.
115
The Contractor’s duty to provide the additional service shall terminate
on A Day unless the HB serves a notice under clause 116 (extending A day to
B day or C day).
116
If the HB is not successful in finding an alternative provider to take on
the provision of the additional service from A day, then it shall notify the
Contractor in writing of this fact no later than one month before A day, and-
64
Standard General Medical Services Contract (12.03.04)
116.1
in a case where A Day is three months after service of the opt out
notice, the Contractor shall continue to provide the additional service until B
Day unless at least one month before B Day it receives a notice in writing
from the HB under clause 117 that despite using its reasonable endeavours,
it has failed to find an alternative provider to take on the provision of the
additional service from B Day;
116.2
in a case where A Day is six months after the service of the opt
out notice, the Contractor shall continue to provide the additional service
until C Day unless at least one month before C Day it receives a notice
from the HB under clause 121 that it has made an application to the
assessment panel under clause 120 seeking its approval to a decision to
refuse a permanent opt out or to delay the commencement of a permanent
opt out until after C Day.
117
Where in accordance with clause 116.1 the permanent opt out is to
commence on B Day and the HB, despite using its reasonable endeavours, has
failed to find an alternative provider to take on the provision of the additional
service from that day, it shall notify the Contractor in writing of this fact at
least one month before B Day, in which case the Contractor shall continue to
provide the additional service until C Day unless at least one month before C
Day it receives a notice from the HB under clause 120 that it has applied to the
assessment panel under clause 119 seeking the approval of the assessment panel
to a decision to refuse a permanent opt out or to postpone the commencement
of a permanent opt out until after C Day.
118.
As soon as is reasonably practicable and in any event within 7 days of
the HB serving a notice under clause 117, the HB shall enter into discussions
with the Contractor concerning the support that the HB may give to the
65
Standard General Medical Services Contract (12.03.04)
Contractor or other changes which the HB or the Contractor may make in
relation to the provision of the additional service until C Day.
119.
The HB may, if it considers that there are exceptional circumstances
make an application to the assessment panel for approval of a decision to-
119.1
refuse a permanent opt-out; or
119.2
postpone the commencement of a permanent opt-out until after C
Day.
120.
As soon as practicable after making an application under clause 119 to
the assessment panel the HB shall notify the Contractor in writing that it has
made such an application.
121.
Where the assessment panel-
121.1 approves a decision to refuse an opt out pursuant to paragraph
3(14)(a) of Schedule 2 to the Regulations; or
121.2 recommends that a permanent opt out be refused pursuant to
paragraph 3(15)(b)(ii) of Schedule 2 to the Regulations,
the HB shall notify the Contractor in writing that it may not opt out of the
additional service.
122.
Where the HB notifies the Contractor under clause 121, the Contractor
may not serve a preliminary opt out notice in respect of that additional service for
a period of 12 months beginning with the date of service of the HB’s notice
under that clause unless there has been a change in the circumstances of the
Contractor in relation to its ability to deliver services under the contract.
66
Standard General Medical Services Contract (12.03.04)
123.
Where the assessment panel-
123.1 recommends a different date for the commencement of the
permanent opt-out;
123.2 approves the HB’s application to postpone a permanent opt out;
or
123.3 recommends an earlier date to that proposed by the HB in its
application,
the HB shall in accordance with the decision of the assessment panel notify
the Contractor in writing of its decision and the notice shall specify the
date of the commencement of the permanent opt out. The permanent opt out
shall commence from that date.
124
Where the assessment panel rejects the HB’s application, the HB shall
notify the Contractor in writing that there shall be a permanent opt out and the
permanent opt out shall commence on C Day or 28 days after the date of service
of the HB’s notice, whichever is the later.
125
If the assessment panel has not reached a decision on the HB’s
application under clause 119 before C Day, the Contractor’s obligation to
provide the additional service shall continue until a notice is served on it by the
HB under clause 123 or 124.
126
Nothing in clauses 110 to 125 above shall prevent the Contractor and
the HB from agreeing a different date for the termination of the Contractor’s
duty under the Contract to provide the additional service and, accordingly,
varying the Contract in accordance with clause 475.
67
Standard General Medical Services Contract (12.03.04)
127
The permanent opt out takes effect at 08.00 on the relevant day unless-
127.1 the day is not a working day in which case the opt out shall take
effect on the next working day at 08.00; or
127.2 the HB and the Contractor agree a different day or time.
128.
Any decision or determination by the assessment panel for the
purposes of clauses 110 to 126 may be reached by a majority.
Out of hours opt outs where the opt out notice is served after 30th
September 2004
129.
Clause 130 to 146 apply where the Contractor wishes to serve or serves
an out of hours opt out notice after 30th September 2004.
130.
Where the Contractor wishes to terminate its obligation to provide out
of hours services which was included in the Contract pursuant to regulation 30
of the Regulations, the Contractor shall notify the relevant HB in writing to that
effect (an out of hours opt out notice).
131.
An out of hours opt out notice shall specify the date from which the
Contractor would like the opt out to take effect, which must be either three or
six months after the date of service of the out of hours opt out notice.
132.
As soon as is reasonably practicable and in any event within 28 days of
receiving the out of hours opt out notice, the HB shall approve the notice and
specify in accordance with clause 133 the date on which the out of hours opt
out is to commence (“OOH Day”). The HB shall notify the Contractor of its
68
Standard General Medical Services Contract (12.03.04)
decision as soon as possible.
133.
The date specified under clause 132 shall be the date specified in the
out of hours opt out notice.
134.
The Contractor may not withdraw an out of hours opt out notice once it
has been approved by the HB under clause 132 without the HB’s agreement.
135.
Following receipt of the out of hours opt out notice, the HB must use its
reasonable endeavours to make arrangements for the Contractor’s registered
patients to receive the out of hours services from an alternative provider from
OOH Day.
136.
Clauses 115 to 128 shall apply to an out of hours opt out as they apply
to a permanent opt out and as if the reference to “A Day” was a reference to
OOH day and the reference in clause 122 to a preliminary opt out notice was a
reference to an out of hours opt out notice.
Out of hours opt out where the opt out notice is served before 1st October
2004
137.
Clause 138 to 152 shall apply where the Contractor wishes to serve or
serves an out of hours opt out notice before 1st October 2004 and in those
clauses-
137.1 “OOH day” is the day specified by the HB for the
commencement of the out of hours opt out in its decision under clause
140;
137.2 “OOHB day” is the day six months after the date of service of
the out of hours opt out notice;
69
Standard General Medical Services Contract (12.03.04)
137.3 “OOHC day” is the day specified by the HB in its decision
under clause 146 to 148 (which must be nine months after the date of
service of the out of hours opt out notice or before 2nd January 2005);
138
If the Contractor wishes to terminate its obligation to provide out of
hours services which was included in this Contract pursuant to regulation 30 of
the Regulations, it shall notify the HB in writing to that effect (out of hours opt
out notice).
139
An out of hours opt out notice shall state the date on which the
Contractor would like the opt out to take effect, which must be either three or
six months after the date of service of the out of hours opt out notice.
140.
As soon as is reasonably practicable and in any event within 28 days of
receiving the out of hours opt out notice, the HB shall approve the notice and
specify in accordance with clause 141 and 142 the date on which the out of
hours opt out is to commence (“OOH Day”).
The HB shall notify the
Contractor in writing of its decision as soon as possible, including reasons for
its decision.
141.
Subject to clause 142, OOH day shall be-
141.1 the date specified in the out of hours opt out notice; or
141.2 any other date before 2nd January 2005.
142.
A HB may not specify under clause 140 a date earlier than the date
specified in the out of hours opt out notice.
70
Standard General Medical Services Contract (12.03.04)
143.
The Contractor may not withdraw an out of hours opt out notice once it
has been approved by the HB under clause 140 without the HB’s agreement.
144.
Following receipt of the out of hours opt out notice, the HB must use its
reasonable endeavours to make arrangements for the Contractor’s registered
patients to receive out of hours services from an alternative provider from OOH
day.
145.
The Contractor’s duty to provide out of hours services shall terminate on
OOH day unless the HB-
145.1 serves a notice under clause 146 (extending OOH day to OOHB
day or OOHC day); or
145.2 makes an application under clause 149 (seeking approval of the
assessment panel to a decision to refuse an opt out or to delay the taking
effect of an opt out until after OOH day).
146
If the HB is not successful in finding an alternative provider to take on
the provision of the out of hours services from OOH Day, then it shall notify the
Contractor in writing of this fact no later than one month before OOH Day,
and-
146.1 in a case where OOH day is three months after service of the opt
out notice, the Contractor shall continue to provide the out of hours
services until OOHB day unless at least one month before OOHB day
the Contractor receives a notice in writing from the HB under clause
148 that despite using its reasonable endeavours, it has failed to find an
alternative provider to take on the provision of the out of hours services
from OOHB day;
71
Standard General Medical Services Contract (12.03.04)
146.2 in a case where OOH day is after the day three months after the
service of the opt out notice, the Contractor shall continue to provide
the out of hours services until OOHC day (which shall be specified by
the HB in accordance with clause 147 and included in its notice to the
Contractor under this Clause) unless at least one month before OOHC
day the Contractor receives a notice from the HB under clause 150
that it has made an application to the assessment panel under clause 149
seeking its approval to a decision to refuse an opt out or to delay the
commencement
147.
of
the
opt
out
until
after
OOHC
day.
OOHC day shall be any day before 2nd January 2005 or the day nine
months after the service of the out of hours opt out notice.
148.
Where in accordance with clause 146.1 the out of hours opt out is to
commence on OOHB day and the HB, despite using its reasonable
endeavours has failed to find an alternative provider to take on the provision
of out of hours services from that day, it shall notify the Contractor in writing of
this fact at least one month before OOHB day, in which case the Contractor
shall continue to provide the out of hours services until OOHC day (which shall
be specified by the HB in accordance with clause 147 and included in its
notice to the Contractor under this clause) unless at least one month before
OOHC day it receives a notice from the HB under clause 150 that it has
applied to the assessment panel under clause 149 seeking the approval of the
assessment panel to a decision to refuse an opt out or to postpone the
commencement
149.
of
an
opt
out
until
after
OOHC
day.
The HB may, if it considers there are exceptional circumstances, make
an application to the assessment panel for approval of a decision to-
149.1 refuse an opt out; or
72
Standard General Medical Services Contract (12.03.04)
149.2 postpone the commencement of an opt out until after-
149.2.1
OOHC day, or
149.2.2
OOH day where OOH day is 1st January 2005, and 1st
January 2005 is nine months or more after the date of the out of hours
opt out notice.
150.
Where OOH day is 1st January 2005, and 1st January 2005 is nine
months or more after the date of the out of hours opt out notice, an application
under clause 149 shall be made at least one month before OOH day.
151.
As soon as practicable after making an application under clause 149 to
the assessment panel, the HB shall notify the Contractor in writing that it has
made such an application.
152.
Clauses 121 to 128 shall apply to an out of hours opt out as they apply
to a permanent opt out and as if the reference to “C day” was a reference to
OOHC day or OOH day where OOH day is 1st January 2005 and 1st January
2005 is nine months or more after the date of the out of hours opt out notice.
Informing patients of opt outs
153.
Prior to any opt out taking effect, the HB and the Contractor shall
discuss how to inform the Contractor’s patients of the proposed opt out.
154.
The Contractor shall, if requested by the HB inform its registered
patients of an opt out and the arrangements made for them to receive the
additional service or out of hours services by-
154.1 placing a notice in the practice’s waiting room; or
73
Standard General Medical Services Contract (12.03.04)
154.2 including the information in the practice leaflet.
155.
In clauses 153 and 154 “opt out” means an out of hours opt out, a
permanent opt out or a temporary opt out.
74
Standard General Medical Services Contract (12.03.04)
PART 1137
ENHANCED SERVICES
156.
[The parties should insert here the details of the enhanced services that
the Contractor has agreed to provide under the Contract (if any) including
details of to whom each of such services will be provided].
157. [ ]
158. [ ]
159. [ ]
160. [ ]
This Part is not required by the Regulations but if the parties agree that the Contractor is
going to provide enhanced services under the GMS Contract, or any relevant Directions direct
the HB to include particular enhanced services if the Contractor so requests, details of such
services, together with any relevant specifications, should be incorporated in this Part.
37
75
Standard General Medical Services Contract (12.03.04)
PART 1238
PATIENTS
Persons to whom services are to be provided39
161. [Except where specifically stated otherwise in respect of particular
services]40 The Contractor shall provide services under the Contract to:
161.1 registered patients,
161.2 temporary residents,
161.3 persons to whom the Contractor is required to provide
immediately necessary treatment under clause 46.3 or 49,
161.4 any person for whom the Contractor is responsible under
regulation 31 of the Regulations41;
Except where specifically indicated in a footnote, this Part is required by the Regulations: see
regulation 18, regulation 26 and Part 2 of Schedule 5.
39 This provision is required by regulation 18(1)(c) of the Regulations which requires the
Contract to specify to whom services under the contract are to be provided.
40 The words in square brackets may be required where the Contractor is providing additional
services not funded by the global sum, enhanced services or out of hours services only to specific
categories of patients (and not all of the patients specified in clauses 161.1 to 161.5 other than
its registered patients other than by virtue of regulation 31 of the Regulations.
41 1. Regulation 31 of the Regulations provides that if the Contract is with any of the persons
specified in a) to c) below, the Contract must require the Contractor to continue providing out
of hours services to patients of an exempt contractor where the Contractor isa) an individual medical practitioner who, on 31 st March 2004, was, or will be,
responsible for providing services during all or part of the out of hours period to
the patients of a medical practitioner who meets the requirements set out in
paragraph 2 below (“exempt contractor”);
b) a partnership where at least one of the partners was, or will be, on 31st March
2004, a medical practitioner responsible for providing such services; or
c) a company in which one or more of the shareholders was, or will be, on 31 st
March 2004, a medical practitioner responsible for providing such services.
38
76
Standard General Medical Services Contract (12.03.04)
161.5 any other person to whom the Contractor is responsible under
arrangements made with another contractor of the kind referred to in
clause 363; and
161.6 any other person to whom the Contractor has agreed to provide
services under the Contract.
Patient registration area
162.
The area in respect of which persons resident in it will, subject to any
other terms of the Contract relating to patient registration, be entitled to
register with the Contractor, or seek acceptance by the Contractor as a
temporary resident, is [
]42.
List of patients
and the Contractor must continue to provide such services until it has opted out of
the provision of out of hours services in accordance with Part 10 of the Contract, or the
HB (or if it is different, the Health Board with whom the exempt contractor holds its
contract)) has or have agreed in writing that the Contractor need no longer provide
some or all of those services to some or all of those patients.
2.
The requirements are thata) the medical practitioner was relieved of responsibility for providing services to
his patients under paragraph 17(2) of Schedule 1 to the National Health Service
(General Medical Services) (Scotland) Regulations 1995; and
b) hea. has entered or will be entering into a contract which does not include out
of hours services pursuant to paragraph 1(b) above,
b. is one of two or more individuals practising in partnership who have
entered or will be entering into a contract which does not includes out of
hours services pursuant to paragraph 1(b) above;
c. is the owner of shares in a company which has entered or will be
entering into a contract which does not include out of hours services
pursuant to paragraph 1(b) above.
42 The practice area needs to be specified here – this is required by regulation 18(1)(d) of the
Regulations.
77
Standard General Medical Services Contract (12.03.04)
163.
The
Contractor’s
list
of
patients
is
[open/closed]43.
164
[
165.
The period of time for which the Contractor’s list of patients will be
]
closed is [please specify a period of time, which may not exceed 12 months].
The current number of the Contractor’s registered patients is [please specify].
The number of registered patients (lower than the current number of such
patients and expressed either in absolute terms or as a percentage of the
current number of patients) which if that number were reached would trigger
the re-opening of the Contractor’s list of patients is[please specify]. The
number of registered patients (expressed either in absolute terms or as a
percentage of the number of current patients) which, if that number were
reached, would trigger the re-closure of the Contractor’s list of patients is
[please specify]44.
166.
The HB shall prepare and keep up to date a list of the patients-
166.1 who have been accepted by the Contractor for inclusion in its
list of patients under clause 171 to 176 who have not subsequently been
removed from that list under clauses 187 to 224; and
166.2 who have been assigned to the Contractor under clauses 254 and
255, or clause 256 and 257 and whose assignment has not subsequently
been rescinded.
The Contract must specify whether, at the date the Contract comes into force, its list of
patients will be open or closed. Please delete as appropriate. This clause is required by
regulation 18(1)(e) of the Regulations.
44 This clause is only required if the Contract specifies in accordance with clause 163 that the
Contractor’s list of patients is closed: see regulation 18(4) of the Regulations. The parties are
required to incorporate the information indicated in square brackets.
43
78
Standard General Medical Services Contract (12.03.04)
167 [
]
168 [
]
169 [
]
170 [
]
Application for inclusion in a list of patients
171.
The Contractor may, if its list of patients is open, accept an application
for inclusion in its list of patients made by or on behalf of any person, whether
or not resident in its practice area or included, at the time of that application, in
the list of patients of another contractor or provider of primary medical
services
172.
The Contractor may, if its list of patients is closed, only accept an
application for inclusion in its list of patients from a person who is an
immediate family member of a registered patient whether or not resident in its
practice area or included, at the time of that application, in the list of patients of
another contractor or provider of primary medical services.
173.
Subject to clause 174, an application for inclusion in the Contractor’s
list of patients shall be made by delivering to the practice premises a medical
card or an application signed (in either case) by the applicant or a person
authorised by the applicant to sign on the applicant’s behalf.
174.
An application may be made-
174.1 on behalf of any child-
79
Standard General Medical Services Contract (12.03.04)
174.1.1
by either parent, or in the absence of both parents, the
guardian or other adult person who has care of the child,
174.1.2
by a person duly authorised by a local authority where
the child is in the care of a local authority under the Children
(Scotland) Act 1995, or
174.1.3
by a person duly authorised by a voluntary organisation
by which the child is being accommodated under the provisions of that
Act;
174.2 on behalf of any adult who is incapable of making such an
application or authorising such an application to be made on their
behalf, by the primary carer of that person or by the person authorised
under the Adults with Incapacity (Scotland) Act 2000 to act on the
patient’s behalf.
175.
Where the Contractor accepts an application for inclusion in its list of
patients, the Contractor shall notify the HB in writing as soon as possible.
176.
On receipt of a notice under clause 175, the HB shall include that
person in the Contractor’s list of patients from the date on which the notice is
received, and shall notify the applicant (or, in the case of a child or incapable
adult, the person making the application on their behalf) in writing of the
acceptance.
Temporary residents
177.
The Contractor may if its list of patients is open accept a person as a
temporary resident provided it is satisfied that the person is-
80
Standard General Medical Services Contract (12.03.04)
177.1 temporarily resident away from his normal place of residence
and is not being provided with essential services (or their equivalent)
under any other arrangement in the locality where he is temporarily
residing; or
177.2 moving from place to place and not for the time being resident
in any place.
178.
For the purposes of clause 177, a person shall be regarded as
temporarily resident in a place if, when he arrives in that place, he intends to
stay there for more than 24 hours but not more than three months.
179.
Where the Contractor wishes to terminate its responsibility for a
person accepted as a temporary resident before the end of three months or such
shorter period for which it agreed to accept him as a patient, the Contractor
shall notify the patient either orally or in writing and its responsibility for that
person shall cease 7 days after the date on which the notification was given.
180.
At the end of three months, or on such earlier date as its responsibility
for the patient has come to an end, the Contractor shall notify the HB in
writing of any person whom it accepted as a temporary resident.
Refusal of applications for inclusion in the list of patients or for acceptance
as a temporary resident
181.
The Contractor shall only refuse an application made under clause 171
to 180 if it has reasonable grounds for doing so which do not relate to the
applicant’s race, gender, social class, age, religion, sexual orientation,
appearance, disability or medical condition.
81
Standard General Medical Services Contract (12.03.04)
182.
The reasonable grounds referred to in clause 181 shall, in the case of
applications made under clauses 171 to 176 include the ground that the
applicant does not live in the Contractor’s practice area.
183.
If the Contractor refuses an application made under clauses 171 to 180,
it shall, within 14 days of its decision, notify the applicant (or, in the case of a
child or incapable adult, the person making the application on their behalf) in
writing of the refusal and the reason for it.
184.
The Contractor shall keep a written record of refusals of applications
made under clauses 171 to 176 and of the reasons for them and shall make this
record available to the HB on request.
Patient preference of practitioner
185.
Where the Contractor has accepted an application for inclusion in its
list of patients, it shall-
185.1 notify the patient (or, in the case of a child or incapable adult, the
person making the application on their behalf) of the patient’s right to
express a preference to receive services from a particular performer or
class of performer either generally or in relation to any particular
condition; and
185.2 record in writing any such preference expressed by or on behalf
of the patient.
186.
The Contractor shall endeavour to comply with any preference
expressed under clause 185 but need not do so if the preferred performer has
reasonable grounds for refusing to provide services to the patient, or does not
routinely perform the service in question within the practice.
82
Standard General Medical Services Contract (12.03.04)
Removals from the list at the request of the patient
187.
The Contractor shall notify the HB in writing of any request for
removal from its list of patients received from a registered patient.
188.
Where the HB receives notification from the Contractor under clause
187, or receives a request from the patient to be removed from the Contractor’s
list of patients, it shall remove that person from the Contractor’s list of patients.
189.
A removal under clause 188 shall take effect-
189.1 on the date on which the HB receives notification of the
registration of the person with another provider of essential services (or
their equivalent); or
189.2 14 days after the date on which the notification or request made
under clause 187 or 188 respectively is received by the HB,
whichever is the sooner.
190.
The HB shall, as soon as practicable, notify in writing-
190.1
the patient; and
190.2 the Contractor
that the patient’s name will be or has been removed from the Contractor’s
list of patients on the date referred to in clause 189.
191.
In clauses 190, 192, 201.1, 207, 208, 213, 214 and 220 a reference to a
request received from, or advice, information or notification required to be
83
Standard General Medical Services Contract (12.03.04)
given to, a patient shall include a request received from or advice,
information or notification required to be given to-
191.1 in the case of a patient who is a child, a parent or other person
referred to in clause 174.1; or
191.2 in the case of an adult patient who is incapable of making the
relevant request or receiving the relevant advice, information or
notification, a relative or the primary carer of the patient.
Removals from the list at the request of the Contractor
192.
Subject to clauses 202 to 208, where the Contractor has reasonable
grounds for wishing a patient to be removed from its list of patients which do
not relate to the applicant’s race, gender, social class, age, religion, sexual
orientation, appearance, disability or medical condition, the Contractor shall-
192.1 notify the HB in writing that it wishes to have the patient
removed; and
192.2 subject to clause 193, notify the patient in writing of its specific
reasons for requesting removal.
193.
Where, in the reasonable opinion of the Contractor, the circumstances
of the removal are such that it is not appropriate for a more specific reason to
be given and there has been an irrevocable breakdown in the relationship
between the patient and the Contractor, the reason given under clause 192
may consist of a statement that there has been such a breakdown.
194.
Except in the circumstances specified in clause 195, the Contractor may
only request a removal under clause 0, if, within the period of 12 months prior
84
Standard General Medical Services Contract (12.03.04)
to the date of its request to the HB, it has warned the patient that he is at risk
of removal and explained to him the reasons for this.
195.
The circumstances referred to in clause 194 are that-
195.1
the reason for removal relates to a change of address;
195.2
the Contractor has reasonable grounds for believing that
the issue of such a warning would be harmful to the physical or
mental health of the patient or would put at risk the safety of one or
more of the persons specified in clause 196; or
195.3
it is, in the opinion of the Contractor, not otherwise
reasonable or practical for a warning to be given.
196
The persons referred to in clause 195 are-
196.1
if the Contractor is an individual medical practitioner, the
Contractor;
196.2
if the Contractor is a partnership, a partner in the
partnership;
196.3
if the Contractor is a company, a legal and beneficial
owner of shares in that company;
196.4
a member of the Contractor’s staff;
196.5
a person engaged by the Contractor to perform or assist
in the performance of services under the Contract; or
85
Standard General Medical Services Contract (12.03.04)
196.6
any other person present on the practice premises or in the
place where services are being provided to the patient under the
Contract.
197.
The Contractor shall record in writing the date of any warning given in
accordance with clause 194 and the reasons for giving such a warning as
explained to the patient, or the reason why no such warning was given.
198.
The Contractor shall keep a written record of removals under clause
192 which shall include the reason for removal given to the patient, the
circumstances of the removal and in cases where clause 193 applies, the
grounds for a more specific reason not being appropriate, and the Contractor
shall make this record available to the HB on request.
199.
A removal requested in accordance with clause 192 shall, subject to
clause 200, take effect from the date on which the HB receives notification of
the registration of the person with another provider of essential services (or
their equivalent), or the eighth day after the HB receives the notice, whichever
is the sooner.
200.
Where, on the date on which the removal would take effect under
clause 199, the Contractor is treating the patient at intervals of less than seven
days, the Contractor shall notify the HB in writing of that fact and the
removal shall take effect on the eighth day after the HB receives notification
from the Contractor that the person no longer needs such treatment, or on the
date on which the person Health Board receives notification of the registration
of the person with another provider of essential services, (or their equivalent)
whichever is the sooner.
86
Standard General Medical Services Contract (12.03.04)
201.
The HB shall notify in writing-
201.1
the patient; and
201.2 the Contractor
that the patient’s name has been or will be removed from the Contractor’s
list of patients on the date referred to in clause 199 or 200.
Removal of violent patients from the list
202.
Where the Contractor wishes a patient to be removed from its list of
patients with immediate effect on the grounds that-
202.1 the patient has committed an act of violence against any of the
persons specified in clause 203 or behaved in such a way that any such
person has feared for that person’s own safety; and
202.2 the contractor has reported the incident to the police or the
Procurator Fiscal.
the Contractor shall notify the HB in accordance with clause 204.
203.
The persons referred to in clause 202 are-
203.1
if the Contract is with an individual medical practitioner,
that individual;
203.2
if the Contract is with a partnership, a partner in that
partnership;
87
Standard General Medical Services Contract (12.03.04)
203.3
if the Contract is with a company, a legal and beneficial
owner of shares in that company;
203.4
a member of the Contractor’s staff;
203.5
a person employed or engaged by the Contractor to
perform or assist in the performance of services under the Contract;
or
203.6
any other person present on the practice premises or in the
place
where services were provided to the patient under the
Contract.
204.
Notification under clause 202 may be given by any means
including telephone or fax but if not given in writing shall subsequently be
confirmed in writing within seven days (and for this purpose a faxed
notification or transmission by electronic means
205.
is not a written one).
The HB shall acknowledge in writing receipt of a request from
the Contractor under clause 202.
206.
A removal requested in accordance with clause 202 shall take effect at
the time the Contractor makes the telephone call to the HB, or sends or
delivers the notification to the HB.
207.
Where, pursuant to clauses 202 to 206, the Contractor has notified the
HB that it wishes to have a patient removed from its list of patients, it shall
inform the patient concerned unless-
207.1 it is not reasonably practicable for it to do so; or
88
Standard General Medical Services Contract (12.03.04)
207.2 it has reasonable grounds for believing that to do so would be
harmful to the physical or mental health of the patient or would put at
risk the safety of one or more of the persons specified in clause 203.
208.
Where the HB has removed a patient from the Contractor’s list of
patients in accordance with clause 206 it shall, give written notice of the
removal to that patient.
209.
Where a patient is removed from the Contractor’s list of patients in
accordance with clauses 202 to 208, the Contractor shall record in the patient’s
medical records that the patient has been removed under this paragraph and
the circumstances leading to his removal.
Removals from the list of patients registered elsewhere
210.
The HB shall remove a patient from the Contractor’s list of patients if
he has subsequently been registered with another provider of essential
services (or their equivalent) in the area of the HB or it has received notice
from another Health Board, a Primary Care Trust, a Local Health Board or a
Health and Social Services Board that the patient has subsequently been
registered with a provider of essential services (or their equivalent) outside the
area of the HB.
211.
A removal in accordance with clause 210 shall take effect on the date
on which notification of registration of the person by the new provider was
received or with the consent of the HB, on such other date as has been agreed
between
212.
the
Contractor
and
the
new
provider.
The HB shall notify the Contractor in writing of persons removed from
its list of patients under clause 210.
89
Standard General Medical Services Contract (12.03.04)
Removals from the list of patients who have moved
213.
Subject to clause 214, where the HB is satisfied that a person on the
Contractor’s list of patients no longer resides in that Contractor’s practice area,
the HB shall,
213.1 inform that patient and the Contractor that the Contractor is no
longer obliged to visit and treat the patient;
213.2 advise the patient in writing either to obtain the Contractor’s
agreement to the continued inclusion of the patient on its list of
patients or to apply for registration with another provider of essential
services (or their equivalent); and
213.3 inform the patient that if, after the expiration of 30 days from the
date of the letter of advice referred to in clause 213.2, he has not acted
in accordance with the advice and informed it accordingly, the HB will
remove him from the Contractor’s list of patients.
214.
If, at the expiration of the period of 30 days referred to in clause 213.3,
the HB has not been notified of the action taken, it shall remove the patient
from the Contractor’s list of patients and inform the patient and the
Contractor accordingly.
215.
Where the address of a patient who is on the Contractor’s list is no
longer known to the HB, the HB shall-
215.1 give to the Contractor notice in writing that it intends, at the end
of the period of six months commencing with the date of the notice, to
remove the patient from the Contractor’s list of patients; and
90
Standard General Medical Services Contract (12.03.04)
215.2 at the end of that period, remove the patient from the Contractor’s
list of patients unless, within that period, the Contractor satisfies the HB
that it is still responsible for providing essential services to that patient.
Removals from the list of patients absent from the United Kingdom etc
216.
The HB shall remove a patient from the Contractor’s list of patients
where it receives notification that that patient-
216.1 intends to be away from the United Kingdom for a period of at
least three months;
216.2 is in Her Majesty’s Forces;
216.3 has been absent from the United Kingdom for a period of more
than three months; or
216.4 has died.
217. A removal in accordance with clause 216 shall take effect-
217.1 in the cases referred to in clauses 216.1 to 216.2 from the date of
the departure or enlistment or the date on which the HB first receives
notification of the departure, enlistment whichever is the later;
217.2 in the cases referred to in clauses 216.3 and 216.4 from the date
on which the HB first receives notification of the absence or death.
218.
The HB shall notify the Contractor in writing of patients removed from
its list of patients under clause 216.
91
Standard General Medical Services Contract (12.03.04)
Removals from the list of patients accepted elsewhere as temporary
residents
219.
The HB shall remove from the Contractor’s list of patients a patient
who has been accepted as a temporary resident by another contractor or other
provider of essential services (or their equivalent) where it is satisfied, after due
inquiry-
219.1 that the patient’s stay in the place of temporary residence has
exceeded three months; and
219.2 that the patient has not returned to his normal place of residence
or any other place within the Contractor’s practice area.
220.
The HB shall notify in writing the Contractor and where practicable,
the patient, of a removal under clause 219.
221.
A notification to the patient under clause 220 shall inform the
patientof-
221.1 the patient’s entitlement to make arrangements for the provision
to the patient of essential services (or their equivalent), including by the
Contractor by whom the patient has been treated as a temporary
resident; and
221.2 the name and address of the HB in whose area the patient is
resident.
Removals from the list of pupils etc at a school
92
Standard General Medical Services Contract (12.03.04)
222.
Where the Contractor provides essential services under the Contract to
persons on the grounds that they are pupils at or staff, or residents of a
school, the HB shall remove from the Contractor’s list of patients any such
patients who do not appear on particulars of persons who are pupils at or
staff, or residents, of that school provided by that school.
223 . Where the HB has made a request to a school to provide the particulars
mentioned in clause 222 and has not received them, it shall consult the
Contractor as to whether it should remove from its list of patients any persons
appearing on that list as pupils at, or staff, or residents of, that school.
224.
The HB shall notify the Contractor in writing of patients removed from
its list of patients under clause 222.
Termination of responsibility for patients not registered with the
Contractor
225.
Where the Contractor-
225.1 has received an application for the provision of medical services
other than essential services-
225.1.1
from a person who is not included in its list of patients,
225.1.2
from a person whom it has not accepted as a temporary
resident, or
225.1.3
on behalf of a person mentioned in clause 225.1.1 or
225.1.2, from one of the persons specified in clause 174; and
93
Standard General Medical Services Contract (12.03.04)
225.2 has accepted that person as a patient for the provision of the
service in question
its responsibility for that patient shall be terminated in the circumstances
referred to in clause 226.
226.
The circumstances referred to in clause 225 are-
226.1 the patient informing the Contractor that he no longer wishes it
to be responsible for provision of the service in question;
226.2 in cases where the Contractor has reasonable grounds for
terminating its responsibility which do not relate to the person’s race,
gender, social class, age, religion, sexual orientation, appearance,
disability or medical condition, the Contractor informing the patient
that it no longer wishes to be responsible for providing him with the
service in question; or
226.3 it comes to the notice of the Contractor that the patient-
226.3.1 no longer resides in the area for which the Contractor has
agreed to provide the service; or
226.3.2 is no longer included in the list of patients of another
Contractor to whose registered patients the Contractor has agreed to
provide that service.
227.
If the Contractor wishes to terminate its responsibility for a patient
under clause 226.2, it shall notify the patient of the termination and the reason
for it.
94
Standard General Medical Services Contract (12.03.04)
228.
The Contractor shall keep a written record of terminations under
clause 225 to 227 and of the reasons for them and shall make this record
available to the HB on request.
229.
A termination under clause 226.2 shall take effect-
229.1 from the date on which the notice is given where the grounds for
termination are those specified in clause 202; or
229.2 in all other cases, 14 days from the date on which the notice is
given.
Closure of lists of patients
230.
Where the Contractor wishes to close its list of patients, it shall notify
the HB in writing to that effect.
231.
Within a period of 7 days beginning with the date of receipt of the
notification referred to in clause 230, or, if that is not reasonably practicable,
as soon as is practicable thereafter, the HB shall enter into discussions with
the Contractor concerning the support which the HB may give the Contractor,
or other changes which the HB or the Contractor may make, which would
enable the Contractor to keep its list of patients open. In these discussions,
both parties shall use reasonable endeavours to achieve the aim of keeping
the Contractor’s list of patients open.
232.
The discussions referred to in clause 231 shall be completed within a
period of 28 days beginning with the date of the HB’s receipt of the
notification referred to in clause 230, or within such longer period as the
parties may agree.
95
Standard General Medical Services Contract (12.03.04)
233.
If, following the discussions referred to in clause 231, the HB and the
Contractor reach agreement that the Contractor’s list of patients should remain
open, the HB shall send full details of the agreement in writing to the
Contractor. The HB and the Contractor shall comply with the terms of any
agreement reached.
234.
If, following the discussions referred to in clause 231-
234.1 the HB and the Contractor reach agreement that the Contractor’s
list of patients should close; or
234.2 the HB and the Contractor fail to reach agreement and the
Contractor still wishes to close its list of patients,
the Contractor shall send a closure notice to the HB.
235 A closure notice shall be submitted in the form specified in Schedule 4 to
this Contract, and shall include the following details which (in a case falling
within clause 234.1) have been agreed between the parties or (in a case falling
within clause 234.2) are proposed by the Contractor-
235.1 the period of time (which may not exceed 12 months) for which
the Contractor’s list of patients will be closed;
235.2 the current number of the Contractor’s registered patients;
235.3 the number of registered patients (lower than the current number
of such patients, and expressed either in absolute terms or as a
percentage of the number of such patients specified pursuant to clause
235.2) which, if that number were reached, would trigger the reopening of the Contractor’s list of patients;
96
Standard General Medical Services Contract (12.03.04)
235.4 the number of registered patients (expressed either in absolute
terms or as a percentage of the number of such patients specified
pursuant to clause 235.2) which, if that number were reached, would
trigger the re-closure of the Contractor’s list of patients; and
235.5 any withdrawal from or reduction in provision of any additional
or enhanced services which had previously been provided under the
Contract.
236.
The HB shall forthwith acknowledge receipt of the closure notice in
writing to the Contractor.
237.
Before the HB reaches a decision as to whether to approve or reject the
closure notice under clause 239, the HB and the Contractor may enter into
further discussions concerning the details of the closure notice as specified in
clause 235, with a view to reaching agreement: and, in particular, if the parties
are unable to reach agreement regarding the period of time for which the
Contractor’s list of patients will be closed, that period shall be twelve months.
238.
The Contractor may not withdraw a closure notice for a period of three
months beginning with the date on which the HB has received the notice,
unless the HB has agreed otherwise in writing.
239.
Within a period of 14 days beginning with the date of receipt of the
closure notice, the HB shall approve or reject the closure notice and shall
notify the Contractor of its decision in writing as soon as possible.
240.
Approval of the closure notice under clause 239 includes approval of
the details specified in accordance with clause 235 (or, where those details are
97
Standard General Medical Services Contract (12.03.04)
revised following discussions under clause 237, approval of those details as so
revised).
Approval of closure notice by the HB
241.
If the HB approves the closure notice in accordance with clause 239, the
Contractor shall close its list of patients-
241.1 with effect from a date agreed between the HB and the
Contractor; or
241.2 if no such agreement has been reached, with effect from the date
on which the Contractor receives notification of the HB’s decision to
approve the closure notice.
242.
Subject to clause 243, the Contractor’s list of patients shall remain closed
for the period specified in the closure notice in accordance with clause 235.1
(or, where a period of 12 months has been fixed in accordance with clause 237,
for that period).
243.
The Contractor’s list of patients shall re-open before the expiry of the
period referred to in clause 242 if-
243.1 the number of the Contractor’s registered patients falls to the
number specified in the closure notice in accordance with clause 235.3;
or
243.2 the HB and the Contractor agree that the list of patients should
re-open.
98
Standard General Medical Services Contract (12.03.04)
244
If the Contractor’s list of patients has re-opened pursuant to clause 243.1,
it shall nevertheless close again if, during the period specified in the closure
notice in accordance with 235.1 (or, where the period of 12 months specified
in clause 237 applies, during that period) the number of the Contractor’s
registered patients rises to the number specified in the closure notice in
accordance with clause 235.4.
245
Except in cases where the Contractor’s list of patients is already open
pursuant to clause 243, the HB shall notify the Contractor in writing between
7 and 14 days before the expiry of the period of closure specified in clause
242, confirming the date on which the Contractor’s list of patients will reopen.
246.
Where the details specified in the closure notice in accordance with
clause 235 have been revised following discussions under clause 237,
references in this paragraph to details specified in the closure notice are
references to those details as so revised.
Rejection of closure notice by the HB
247
Clause 248 to 252 apply where the HB rejects the closure notice in
accordance with clause 239.
248.
The Contractor or the HB shall not refer the matter for determination in
accordance with the NHS dispute resolution procedure (or, where applicable,
commence court proceedings) until the assessment panel has given its
determination in accordance with clauses 249 to 253 and paragraph 31(6) and
(7) of Schedule 5 to the Regulations.
99
Standard General Medical Services Contract (12.03.04)
249.
The HB must ensure that the assessment panel is appointed as soon as is
practicable to consider and determine whether the Contractor should be
permitted to close its list of patients, and if so, the terms on which it should be
permitted to do so.
250.
The HB shall provide the assessment panel with such information as the
assessment panel may reasonably require to enable it to reach a determination
and shall include in such information any written observations received from
the Contractor.
251.
Where the assessment panel determines pursuant to paragraph 31(7)(a)
of Schedule 5 to the Regulations that the Contractor’s list of patients may close-
251.1 that list shall close on the date specified by the assessment panel
pursuant to paragraph 31(7)(a) of Schedule 5 to the Regulations; and
251.2 that list shall re-open in accordance with the details specified by
the assessment panel pursuant to paragraph 31(7)(b) of Schedule 5 to the
Regulations.
252.
Where the assessment panel rejects the list closure pursuant to
paragraph 31(7)(b) of Schedule 5 to the Regulations -
252.1 that list shall remain open, and the HB and the Contractor shall
enter into discussions with a view to ensuring that the Contractor
receives support from the HB which will enable it to continue to
provide services safely and effectively;
252.2 the Contractor may not submit a further closure notice as
described in clause 235 until-
100
Standard General Medical Services Contract (12.03.04)
252.2.1 the expiry of a period of three months beginning with the date
of the assessment panel’s determination; or
252.2.2 (if applicable) the final determination of the NHS dispute
resolution procedure (or any court proceedings),
whichever is the later, unless there has been a change in the
circumstances of the Contractor which affects its ability to deliver
services under the Contract.
253. Any decision or determination by the assessment panel for the
purposes of clauses 247 to 252 or clauses 259 to 262 may be reached by
a majority.
Assignment of patients to lists: open lists
254.
The HB may, subject to clause 258, assign a new patient to the
Contractor whose list of patients is open.
255.
In this clause, and in clauses 256 to 257 and clauses 259 to 268, a “new”
patient means a person who-
255.1 is resident (whether or not temporarily) within the area of the
HB;
255.2 has been refused inclusion in a list of patients of, or has not been
accepted as a temporary resident by a contractor whose premises are
within such an area; and
255.3 wishes to be included in the list of patients of the Contractor
whose practice premises are within that area.
101
Standard General Medical Services Contract (12.03.04)
Assignment of patients to lists: closed lists
256
The HB may not assign a patient to the Contractor where it has closed
its list of patients except in the circumstances specified in clause 257.
257.
The HB may, subject to clause 258, assign a new patient to the
Contractor when it has closed its list of patients if the Contractor’s practice
premises are within the HB’s area, and-
257.1 most or all of the providers of essential services (or their
equivalent) whose practice premises are within the HB’s area have closed
their lists of patients;
257.2 the assessment panel has determined under paragraph 35(7) of
Schedule 5 to the Regulations that patients may be assigned to the
Contractor, and that determination has not been overturned either by a
determination of the Scottish Ministers or the adjudicator under
paragraph 36(15) of Schedule 5 to the Regulations or (where applicable)
by a court; and
257.3 the HB has entered into discussions with the Contractor in
question regarding the assignment of a patient if such discussions are
required under clause 265.
Factors relevant to assignments
258.
In making an assignment to the Contractor under clauses 254 to 257,
the HB shall have regard to-
258.1 the wishes and circumstances of the patient to be assigned;
102
Standard General Medical Services Contract (12.03.04)
258.2 the distance between the patient’s place of residence and the
Contractor’s practice premises;
258.3 whether, during the six months ending on the date on which the
application for assignment is received by the HB, the patient’s name
has been removed from the list of patients of any contractor in the area
of the HB under clauses 192 to 201 or the equivalent provision in
relation to a section 17C provider in the area of the HB;
258.4 whether the patient’s name has been removed from the list of
patients of any contractor in the area of the HB under clauses 202 to 209
or the equivalent provision in relation to a section 17C provider in the
area of the HB and, if so, whether the Contractor has appropriate
facilities to deal with such a patient;
258.5 such other matters as the HB considers to be relevant.
Assignments to closed lists: determination of the assessment panel
259.
Clause 260 to 262 apply where most or all of the providers of essential
services (or their equivalent) whose practice premises are within the area of the
HB have closed their lists of patients and the HB proposes to assign patients to
contractors who have closed their lists (including the Contractor).
260.
If the HB wishes to assign new patients to the contractors specified in
clause 259, it must prepare a proposal to be considered by the assessment panel,
and the proposal must include details of those contractors to which the HB
wishes to assign new patients.
103
Standard General Medical Services Contract (12.03.04)
261.
The HB must ensure that the assessment panel is appointed to consider
and determine its proposal made under clause 260.
262.
The HB shall notify in writing-
262.1 contractors or section 17C providers whose practice premises are
within the HB’s area which-
262.1.1 have closed their list of patients, and
262.1.2 may, in the opinion of the HB, be affected by the determination
of the assessment panel; and
262.2 the area medical committee for the area of the HB,
that it has referred the matter to the assessment panel.
Assignments to closed lists: NHS dispute resolution procedure relating to
determinations of the assessment panel
263.
Where the assessment panel determines in accordance with paragraph
35(5) to (9) of Schedule 5 to the Regulations that the HB may assign new
patients to contractors which have closed their lists of patients, and the
Contractor is specified in that determination , the Contractor may refer the
matter to the Scottish Ministers to review the determination of the assessment
panel pursuant to the NHS dispute resolution procedure
as modified by
paragraph 36(3) of Schedule 5 to the Regulations.
264.
Where, pursuant to clause 263, the Contractor wishes to refer the
matter to the Scottish Ministers either by itself, or jointly with other contractors
specified in the determination of the assessment panel, it must, either by itself
104
Standard General Medical Services Contract (12.03.04)
or together with the other contractors, within the period of 7 days beginning
with the date of the determination of the assessment panel, send to the Scottish
Ministers a written request for dispute resolution which shall include or be
accompanied by-
264.1 the names and addresses of the parties to the dispute;
264.2 a copy of the Contract; and
264.3 a brief statement describing the nature and circumstances of the
dispute.
265.
Where a matter is referred to the Scottish Ministers in accordance with
paragraph 36 of Schedule 5 to the Regulations, it shall be determined
in
accordance with the NHS dispute resolution procedure as modified by
paragraph 36(3) of Schedule 5 to the Regulations.
Assignments to closed lists: assignments of patients by the HB
266.
Before the HB may assign a patient to the Contractor where it has closed
its list, it shall, subject to clause 268, enter into discussions with the Contractor
regarding additional support that the HB can offer the Contractor, and the HB
shall use its best endeavours to provide appropriate support.
267.
In the discussions referred to in clause 266, both parties shall use
reasonable endeavours to reach agreement.
268.
The requirement in clause 266 to enter into discussions applies-
268.1 to the first assignment of a patient to the Contractor; and
105
Standard General Medical Services Contract (12.03.04)
268.2 to any subsequent assignment to that Contractor to the extent
that it is reasonable and appropriate having regard to the numbers of
patients who have been or may be assigned to it and the period of time
since the last discussions under clause 266 took place.
106
Standard General Medical Services Contract (12.03.04)
PART 13
PRESCRIBING AND DISPENSING45
269.
The Contractor shall comply with any directions given by the Scottish
Ministers for the purposes of section 17N(6) of the Act as to the drugs,
medicines or other substances which may or may not be ordered for patients
in the provision of medical services under the Contract46.
Prescribing
270.
The Contractor shall ensure that any prescription form for drugs,
medicines or appliances issued by a prescriber complies as appropriate with
the requirements in clauses 271 to 274.
271.
Subject to clauses 275 to 283, a prescriber shall order any drugs,
medicines or appliances which are needed for the treatment of any patient
who is receiving treatment under the contract by issuing to that patient a
prescription form and such a prescription form shall not be used in any other
circumstances.
272.
In issuing any prescription form the prescriber shall sign the prescription
form in ink with the prescriber’s initials, or forenames and surname in the
prescriber’s own handwriting and not by means of a stamp, and shall so sign
only after particulars of the order have been inserted in the prescription form
and-
272.1 the prescription form shall not refer to any previous prescription
form; and
This Part is required by the Regulations (see Part 3 of Schedule 5) and where indicated in the
footnotes by the Act.
46 This clause is required by section 17N(6) of the Act.
45
107
Standard General Medical Services Contract (12.03.04)
272.2 a separate prescription form shall be used for each patient.
273.
In a case of urgency a prescriber may request a pharmacist to dispense a
drug before a prescription form is issued, but only if:
273.1 that drug is not a Scheduled drug;
273.2 that drug is not a controlled drug within the meaning of the
Misuse of Drugs Act 1971, other than a drug which is for the time
being specified in Schedules 4 or 5 to the Misuse of Drugs Regulations
2001; and
273.3 the prescriber undertakes to furnish the pharmacist, within 72
hours, with a prescription form completed in accordance with clause
272.
274.
In a case of urgency a prescriber may request a pharmacist to dispense
an appliance before a prescription form is issued, but only if-
274.1 that appliance does not contain a Scheduled drug or a controlled
drug within the meaning of the Misuse of Drugs Act 1971, other than a
drug which is for the time being specified in Schedule 5 to the Misuse
of Drugs Regulations 2001;
274.2 in the case of a restricted availability appliance, the patient is a
person, or it is for a purpose, specified in the Drug Tariff; and
274.3 the prescriber undertakes to furnish the pharmacist, within 72
hours, with a prescription form completed in accordance with clause
272.
108
Standard General Medical Services Contract (12.03.04)
Restrictions on prescribing by medical practitioners
275.
In the course of treating a patient to whom a medical practitioner is
providing treatment under the Contract, a medical practitioner shall not order
on a prescription form a drug, medicine or other substance specified in any
directions given by the Scottish Ministers under section 17N(6) of the Act as
being drugs, medicines or other substances which may not be ordered for
patients in the provision of medical services under the Contract but may,
subject to clause 429, prescribe such a drug or other substance for that patient
in the course of that treatment under a private arrangement.
276.
In the course of treating a patient to whom he is providing treatment
under the Contract, a medical practitioner shall not order on a prescription
form a drug, medicines or other substance specified in any directions given by
the Scottish Ministers under section 17N(6) of the Act as being a drug which
can only be ordered for specified patients and specified purposes unless-
276.1 that patient is a person of the specified description;
276.2 that drug is prescribed for that patient only for the specified
purpose; and
276.3 the practitioner endorses the form with the reference SLS,
but may, subject to clause 429, prescribe such a drug, medicine or other
substance for that patient in the course of that treatment under a private
arrangement.
109
Standard General Medical Services Contract (12.03.04)
277.
In the course of treating a patient to whom a medical practitioner is
providing treatment under the Contract, a medical practitioner shall not order
on a prescription form a restricted availability appliance unless-
277.1 the patient is a person, or it is for a purpose, specified in the
Drug Tariff; and
277.2 the practitioner endorses the face of the form with the reference
SLS,
but may, subject to clause 429, prescribe such an appliance for that patient
in the course of that treatment under a private arrangement.
Restrictions on prescribing by supplementary prescribers
278.
The Contractor shall have arrangements in place to secure that a
supplementary prescriber will –
278.1 give a prescription for a prescription only medicine;
278.2
administer
a
prescription
only
medicine
for
parenteral
administration; or
278.3 give directions for the administration of a prescription only
medicine for parenteral administration,
as a supplementary prescriber only under the conditions set out in clause 279.
279.
The conditions referred to in clause 278 are that -
110
Standard General Medical Services Contract (12.03.04)
279.1 the supplementary prescriber satisfies the applicable conditions
set out in article 3B(3) of the POM Order (prescribing and
administration by supplementary prescribers), unless those conditions do
not apply by virtue of any of the exemptions set out in the subsequent
provisions of that Order;
279.2 the medicine is not a controlled drug within the meaning of the
Misuse of Drugs Act 1971;
279.3 the drug, medicine or other substance is not specified in any
directions given by the Scottish Ministers under section 17N(6) of the
Act as being a drug, medicine or other substance which may not be
ordered for patients in the provision of medical services under the
Contract;
279.4 the drug, medicine or other substance is not specified in any
directions given by the Scottish Ministers under section 17N(6) of the
Act as being a drug, medicine or other substance which can only be
ordered for specified patients and specified purposes unless -
279.4.1 the patient is a person of the specified description,
279.4.2 the medicine is prescribed for that patient only for the specified
purposes, and
279.4.3 if the supplementary prescriber is giving a prescription, he
endorses the face of the form with the reference SLS.
111
Standard General Medical Services Contract (12.03.04)
280.
Where the functions of a supplementary prescriber include prescribing,
the Contractor shall have arrangements in place to secure that that person will
only give a prescription for -
280.1 an appliance; or
280.2 a medicine which is not a prescription only medicine,
as a supplementary prescriber under the conditions set out in clause 281.
281. The conditions referred to in clause 280 are that -
281.1 the supplementary prescriber acts in accordance with a clinical
management plan which is in effect at the time the supplementary
prescriber acts and which contains the following particulars -
281.1.1 the name of the patient to whom the plan relates,
281.1.2 the illness or conditions which may be treated by the
supplementary prescriber,
281.1.3 the date on which the plan is to take effect, and when it is to be
reviewed by the medical practitioner or dentist who is a party to the
plan,
281.1.4 reference to the class or description of medicines or types of
appliances which may be prescribed or administered under the plan,
112
Standard General Medical Services Contract (12.03.04)
281.1.5 any restrictions or limitations as to the strength or dose of any
medicine which may be prescribed or administered under the plan,
and any period of administration or use of any medicine or appliance
which may be prescribed or administered under the plan,
281..1.6 relevant warnings about known sensitivities of the patient to,
or known difficulties of the patient with, particular medicines or
appliances,
281.1.7 the arrangements for notification of -
281.1.7.1 suspected or known adverse reactions to any medicine
which may be prescribed or administered under the plan, and
suspected or known adverse reactions to any other medicine taken
at the same time as any medicine prescribed or administered under
the plan,
281.1.7.2 incidents occurring with the appliance which might lead,
might have led or has led to the death or serious deterioration of
state of health of the patient, and
281.1.7.3 the circumstances in which the supplementary prescriber
should refer to, or seek the advice of, the medical practitioner or
dentist who is a party to the plan;
281.2 the supplementary prescriber has access to the health records of the
patient to whom the plan relates which are used by any medical
practitioner or dentist who is a party to the plan;
113
Standard General Medical Services Contract (12.03.04)
281.3 if it is a prescription for a medicine, the medicine is not a
controlled drug within the meaning of the Misuse of Drugs Act 1971;
281.4 if it is a prescription for a drug, medicine or other substance,
that drug, medicine or other substance is not specified in any directions
given by the Scottish Ministers under section 17N(6) of the Act as being
a drug, medicine or other substance which may not be ordered for
patients in the provision of medical services under the Contract;
281.5 if it is a prescription for a drug, medicine or other substance,
that drug, medicine or other substance
is not specified in any
directions given by the Scottish Ministers under section 17N(6)of the
Act as being a drug, medicine or other substance which can only be
ordered for specified patients and specified purposes unless -
281.5.1
the patient is a person of the specified description,
281.5.2
the medicine is prescribed for that patient only for the
specified purposes, and
281.5.3
when giving the prescription, he endorses the face of the
form with the reference SLS;
281.6 if it is a prescription for a medicine -
114
Standard General Medical Services Contract (12.03.04)
281.6.1 the medicine is the subject of a product licence, a marketing
authorisation or a homeopathic certificate of registration granted by
the licensing authority or the European Commission, or
281.6.2 subject to clause 283, the use of the medicine is for the purposes
of a clinical trial, and either the trial is the subject of a clinical trial
certificate issued in accordance with the Medicines Act 1968, or a
clinical trial certificate is not needed in respect of that trial by virtue of
any exemption conferred by or under that Act
281.7 if it is a prescription for an appliance, the appliance is listed in
Parts 2 to 6 and Part 8 to 10 of the Drug Tariff; and
281.8 if it is a prescription for a restricted availability appliance -
281.8.1
the patient is a person of a description mentioned in the
entry in Part 3 of the Drug Tariff in respect of that appliance,
281.8.2
the appliance is prescribed only for the purposes
specified in respect of that person in that entry, and
281.8.3
when
giving
the
prescription,
the
supplementary
prescriber endorses the face of the form with the reference SLS.
282.
In clause 281.1, “clinical management plan” means a written plan
(which may be amended from time to time) relating to the treatment of an
individual patient agreed by—
282.1 the patient to whom the plan relates;
115
Standard General Medical Services Contract (12.03.04)
282.2 the medical practitioner or dentist who is a party to the plan; and
282.3 any supplementary prescriber who is to prescribe, give directions
for administration or administer under the plan.
283
In relation to any time from the coming into force of any regulations
made by the Secretary of State under section 2(2) of the European Communities
Act 1972 to implement Directive 2001/83/EC on the Community code
relating to medicinal products for human use, clause 281.6.2 shall be read as
if it referred to a clinical trial which has been authorised, or is treated as
having been authorised by the licensing authority for the purposes of those
Regulations.
Excessive prescribing
284.
The Contractor shall not prescribe drugs, medicines or appliances
whose cost or quantity, in relation to any patient, is, by reason of the character
of the drug, medicine or appliance in question, in excess of that which was
reasonably necessary for the proper treatment of that patient. In considering
whether a Contractor has breached its obligations under this clause, the HB
shall seek the views of the area medical committee for its area.
Provision of dispensing services
285.
The Contractor may secure the provision of dispensing services to its
registered patients under the Contract only if it is authorised or required to do
so by the HB in accordance with clauses 286 to 289.
116
Standard General Medical Services Contract (12.03.04)
286.
Where the HB is satisfied after consultation with the area
pharmaceutical committee, that a person, who is a registered patient of the
Contractor , by reason of distance, inadequacy of means of communication or
other exceptional circumstances will have serious difficulty in obtaining from
a pharmacist any drugs, medicines or appliances other than scheduled drugs,
required for that person’s treatment, the HB shall require or authorise the
Contractor to supply such drugs, medicines and appliances to that person
until further notice ;
287.
Notwithstanding anything contained in clause 286 –
287.1 the Contractor shall not be required to undertake the supply of
drugs, medicines and appliances under clause 286 if the Contractor
satisfies the Health Board that the Contractor is not in the habit of
dispensing drugs, medicines and appliances for the Contractor’s
patients, and
287.2 the Contractor shall be entitled to receive reasonable notice from
the Health Board that the Contractor is required to undertake the
supply of drugs, medicines and appliances under clause 286 or that
such supply is to be discontinued.
288.
Unless drugs, medicines or appliances have been ordered on a
prescription form by a supplementary prescriber or an independent nurse
prescriber, a Contractor, who is required by the HB to supply drugs,
medicines and appliances under clause 286 to a patient, in the course of
treating that patient –
288.1
shall, subject to clause 291 record on a prescription form
completed in accordance with clause 272, an order for supply of any
drugs, medicines or appliances which are needed for the treatment of that
patient, but shall not be required to issue that form to that patient;
117
Standard General Medical Services Contract (12.03.04)
288.2
shall supply those drugs, medicines or appliances for that
patient under clause 286 but –
288.2.1
shall not supply under clause 286 for that patient any
Scheduled drug specified as being a drug, medicine or other substance
which may not be ordered for patients in the provision of medical services
under the Contract, except that, where the Contractor has ordered a drug
which has an appropriate non-proprietary name either by that name or by
its formula, the Contractor may supply a drug which has the same
specification notwithstanding that it is such a Scheduled drug (but in the
case of a drug which combines more than one drug, only if the
combination has an appropriate non-proprietary name);
288.2.2
shall supply under clause 286 for that patient any
Scheduled drug specified as being a drug, medicine or other substance
which may only be ordered for specific patients and purposes only where
that patient is a person of the specified description and that drug,
medicine or other substance is supplied to that patient only for the
specifed purpose.
288.2.3.
shall supply under clause 286 for that patient a restricted
availability appliance only if it is for a patient in a category or persons or a
purpose specified in the Drug Tariff
288.3
may supply for that patient with the Contractor’s consent, in
respect of that treatment but otherwise than under clause 286, any
Scheduled drug.
289.
The contractor shall comply with any arrangements made by the
Scottish Ministers, or made by a Health Board after consultation with the
are medical committee and the area pharmaceutical committee and
118
Standard General Medical Services Contract (12.03.04)
approved by the Scottish Ministers, under which the Contractor may
obtain and have available any drugs, medicines or appliances which the
Contractor is required or entitled to supply in terms of this paragraph.
290.
Where a patient presents an order on a prescription form for
listed drugs or medicines, or appliances, signed by a supplementary
prescriber or an independent nurse prescriber, to a Contractor who is
required under clause 286 to provide drugs or appliances to that
patient the Contractor may provide to the patient such drugs,
medicines or appliances so ordered as the Contractor supplies in the
nomal course of the Contractor’s practice.
291.
A drug supplied by a Contractor unless administered in person shall
be supplied in a suitable container.
292.
Before supplying the drugs, medicines or appliances recorded on a
prescription form in accordance with clause 288 or providing the drugs or
medicines or appliances ordered on a prescription form signed by a
supplementary prescriber or an independent nurse prescriber in accordance
with clause 290 a Contractor who is required by the Health Board under
clause 286 to provide drugs, medicines or appliances to a patient shall request
any person who makes a declaration on the prescription form claiming either
charge exemption under regulation 7 of the National health Service (Charges
for Drugs and Appliances) (Scotland) Regulations 2001 (“the 2001
Regulations) or charge remission under the National Health Service
(Travelling Expenses and Remission of Charges) (Scotland) (No.2)
Regulations 2003 to produce evidence of the patient’s entitlement to such
exemption or remission.
119
Standard General Medical Services Contract (12.03.04)
293.
Clause 292 shall not apply in respect of claims for exemption under
regulation 7(1)(a) to (f) of the 2001 Regulations where the Contractor has
information in the Contractors possession at the time of supplying the item
which confirms that the patient is entitled to the exemption claimed.
294.
Where the person presenting the prescription form does not show
valid evidence of entitlement and the Contractor, in respect of a claim for
exemption made under regulation 7(1)(a) to (f) of the 2001 Regulations, does
not have evidence in the Contractor’s possession to confirm that the patient is
entitled to make that claim, the Contractor shall mark the patient’s
prescription form accordingly before supplying the prescribed item.
295.
The provisions of clause 429 apply in respect of the provision of any
drugs, medicines or appliances by the Contractor providing dispensing services
as they apply in respect of prescriptions for drugs, medicines and appliances.
296.
Nothing in clauses 285 to 295 shall prevent the Contractor providing a
Scheduled drug or a restricted availability appliance in the course of treating a
patient under a private arrangement.
Provision of drugs, medicines and appliances for immediate treatment or
personal administration
296.
The contractor
296.1 shall provide to a patient any drug, medicine or appliance, not
being a Scheduled drug, where such provision is needed for the
immediate treatment of that patient before a provision can otherwise
be obtained; and
120
Standard General Medical Services Contract (12.03.04)
296.2 may provide to a patient any drug, medicine or appliance, not
being a Scheduled drug, which he personally administers or applies to
that patient,
but shall, in either case, provide a restricted availability appliance only if it is for
a person or a purpose specified in the Drug Tariff. Nothing in this clause
authorises a person to supply any drug or medicine to a patient otherwise
than in accordance with Part 3 of the Medicines Act 1968, or any regulations
or orders made under that Act.
121
Standard General Medical Services Contract (12.03.04)
PART 1447
PERSONS WHO PERFORM SERVICES
Qualifications of performers
297.
Subject to clause 298, no medical practitioner shall perform medical
services under the Contract unless the medical practitioner is-
297.1 included in a primary medical services performers list for the
Health Board which is under a duty to provide or secure the provision
of the service to be performed;
297.2 not suspended from that list or from the Medical Register; and
297.3 not subject to interim suspension under section 41A of the
Medical Act 1983.
298.
Clause 297.1 shall not apply in the case of –
298.1 a medical practitioner employed in Scotland, by a Health Board,
in England and Wales, by a NHS trust, a NHS foundation trust, or in
Northern Ireland by a Health and Social Services Trust, who is providing
services other than primary medical services at the practice premises;
Except where footnotes indicate otherwise, this Part is required by the Regulations (see Part
4 of Schedule 5).
47
122
Standard General Medical Services Contract (12.03.04)
298.2 a person who is provisionally registered under section 15, 15A
or 21 of the Medical Act 1983 acting in the course of his employment in
a resident medical capacity in an approved medical practice; or
298.3 a GP Registrar during the first two months of the GP Registrar’s
training period.
299
No health care professional other than one to whom clauses 297 and 298
apply shall perform clinical services under the Contract unless the health care
professional
is appropriately registered with the health care professional’s
relevant professional body and the health care professional’s registration is
not currently suspended.
300
Where the registration of a health care professional or, in the case of a
medical practitioner, the practitioner’s
inclusion in a list is subject to
conditions, the Contractor shall ensure compliance with those conditions
insofar as they are relevant to the Contract.
301.
No health care professional shall perform any clinical services unless the
Contractor is satisfied that the health care professional has such clinical
experience and training as are necessary to enable the healh care professional
properly to perform such services.
Conditions for employment and engagement
302.
Subject to clauses 303 and 304, the Contractor shall not employ or
engage a medical practitioner (other than one falling within clause 298.2)
unless-
123
Standard General Medical Services Contract (12.03.04)
302.1 that practitioner has provided it with the name and address of
the Health Board on whose primary medical services performers list the
practitioner appears; and
302.2 the Contractor has checked
that the practitioner meets the
requirements in clause 297.
303
Where the employment or engagement of a medical practitioner is
urgently needed and it is not possible to check the matters referred to in
clause 297 in accordance with clause 302.1 before employing or engaging the
practitioner, the practitioner may be employed or engaged on a temporary
basis for a single period of up to 7 days whilst such checks are undertaken.
304.
Where the prospective employee is a GP Registrar, the requirements set
out in clause 302 shall apply with the modifications that-
304.1 the name and address provided under 302.1 may be the name
and address of the Health Board on whose primary medical services
performers list the GP Registrar has applied for inclusion; and
304.2 confirmation that the GP Registrar’s name appears on those
lists shall not be required until the end of the first two months of the
GP Registrar’s training period.
305
The Contractor shall not employ or engage-
305.1
a health care professional other than one to whom clauses
297 and 298 apply unless the Contractor has checked that the health
care professional meets the requirements in clause 299; or
124
Standard General Medical Services Contract (12.03.04)
305.2
a health care professional to perform clinical services unless
the Contractor has taken reasonable steps to satisfy himself that the
health care professional meets the requirements in clause 301.
306.
Where the employment or engagement of a health care professional is
urgently needed and it is not possible to check the matters referred to in
clause 299 in accordance with clause 305 before employing or engaging the
practitioner, the health care professional may be employed or engaged on a
temporary basis for a single period of up to 7 days whilst such checks are
undertaken.
307.
When considering a health care professional’s experience and training
pursuant to clause 305.2, the Contractor shall have regard to any postgraduate or post-registration qualification held by the health care professional,
and any relevant training undertaken by the health care professional and any
relevant clinical experience gained by the health care professional.
308.
The Contractor shall not employ or engage a health care professional to
perform medical services under the Contract unless-
308.1 that person has provided two clinical references, relating to two
recent posts (which may include any current post) as a health care
professional which lasted for three months without a significant break,
or where this is not possible, a full explanation and alternative referees;
and
308.2 the Contractor has checked and is satisfied with the references.
309.
Where the employment or engagement of a health care professional is
urgently needed and it is not possible to obtain and check the references in
accordance with clause 308.1 before employing or engaging the professional,
125
Standard General Medical Services Contract (12.03.04)
the professional may be employed or engaged on a temporary basis for a
single period of up to 14 days whilst the professional’s references are checked
and considered, and for an additional single period of a further 7 days if the
Contractor believes the person supplying those references is ill, on holiday or
otherwise temporarily unavailable.
310.
Where the Contractor employs or engages the same person on more
than one occasion within a period of three months, it may rely on the
references provided on the first occasion, provided that those references are
not more than twelve months old.
311.
Before employing or engaging any person to assist it in the provision of
services under the Contract, the Contractor shall take reasonable care to
satisfy itself that the person in question is both suitably qualified and
competent to discharge the duties for which he is to be employed or engaged.
This duty is in addition to the duties imposed by clause 302 to 310.
312.
When considering the competence and suitability of any person for the
purpose of clause 311, the Contractor shall have regard, in particular, to-
312.1 that person’s academic and vocational qualifications;
312.2 the person’s education and training; and
312.3 the person’s previous employment or work experience.
Training
313.
The Contractor shall ensure that for any health care professional who is-
313.1 performing clinical services under the Contract; or
126
Standard General Medical Services Contract (12.03.04)
313.2 employed or engaged to assist in the performance of such
services
there are in place arrangements for the purpose of maintaining and
updating the health care professional’s skills and knowledge in relation to
the services which the health care professional is providing or assisting in
performing.
314.
The Contractor shall afford to each employee reasonable opportunities
to undertake appropriate training with a view to maintaining that employee’s
competence.
Terms and conditions
315.
The Contractor shall only offer employment to a general medical
practitioner on terms and conditions which are no less favourable than those
contained in the “Model terms and conditions of service for a salaried general
practitioner employed by a GMS practice” published in the British Medical
Association and the NHS Confederation as item 1.2 of the supplementary
documents to the new GMS contract 2003.
Arrangements for GP Registrars
316.
The Contractor shall only employ a GP Registrar for the purpose of
being trained by a GP Trainer with the agreement of the Scottish Ministers and
subject to the conditions in clause 317.
317.
The conditions referred to in clause 316 are that the Contractor shall
not, by reason only of having employed or engaged a GP Registrar, reduce the
total number of hours for which other medical practitioners perform primary
127
Standard General Medical Services Contract (12.03.04)
medical services under the contract or for which other staff assist them in the
performance of those services.
318.
Where the Contractor employs a GP Registrar, the Contractor shall-
318.1 offer the GP Registrar terms of employment in accordance with
the rates and subject to the conditions contained in any Directions
given by the Scottish Ministers to Health Boards under 17M of the Act
concerning the grants, fees, travelling and other allowances payable to
GP Registrars; and
318.2 take into account any guidance issued by the Scottish Ministers
in relation to the GP Registrar scheme.
Independent nurse prescribers and supplementary prescribers
319.
Where-
319.1 the Contractor employs or engages a person who is an
independent nurse prescriber or a supplementary prescriber whose
functions will include prescribing in its practice; or
319.2
a contractor is a partnership and one of the partners is an
independent nurse prescriber or a supplementary prescriber whose
functions will include prescribing; or
319.3 the functions of a person who is an independent nurse prescriber or
a supplementary prescriber whom it already employs or has already
engaged are extended to include prescribing,
it shall notify the HB in writing within the period of seven days beginning
with the date on which the Contractor employed or engaged the person,
128
Standard General Medical Services Contract (12.03.04)
the party became a party to the contract (unless, immediately before
becoming such a party, the person fell under clause 319.1) or the person’s
functions were extended, as the case may be
320
Where-
320.1 the Contractor ceases to employ or engage a person who is an
independent nurse prescriber or a supplementary prescriber whose
functions included prescribing in its practice; or
320.2
the partner in a partnership who is an independent nurse
prescriber or a supplementary prescriber whose functions include
prescribing, ceases to be a partner in a partnership;
320.3 the functions of a person who is an independent nurse prescriber
or a supplementary prescriber whom it employs or engages in its practice
are changed so that they no longer include prescribing in its practice;
or
320.4 the Contractor becomes aware that a person who is an
independent nurse prescriber or a supplementary prescriber whom it
employs or engages has been removed or suspended from the relevant
register,
it shall notify the HB by the end of the second working day after the day
when the event occurred.
321.
The Contractor shall provide the following information when it notifies
the HB in accordance with clause 319-
321.1 the person’s full name;
129
Standard General Medical Services Contract (12.03.04)
321.2 the person’s professional qualifications;
321.3 the person’s identifying number which appears in the relevant
register;
321.4 the date on which the person’s entry in the relevant register was
annotated to the effect that the person was qualified to order drugs,
medicines and appliances for patients;
321.5 the date-
321.5.1
on which the person was employed or engaged, if
applicable; or
321.5.2
the person became a partner in the partnership, if
applicable; or
321.5.3
on which one of the person’s functions became to
prescribe in its practice.
322.
The Contractor shall provide the following information when it notifies
the HB in accordance with clause 320-
322.1 the person’s full name;
322.1 the person’s professional qualifications;
322.3 the peron’s identifying number which appears in the relevant
register;
130
Standard General Medical Services Contract (12.03.04)
322.4 the date-
322.4.1
the person ceased to be employed or engaged in its
practice,
322.4.2
322.4.3
the person ceased to be partner in the partnership,
the person’s functions changed so as no longer to include
prescribing, or
322.4.4
on which the person was removed or suspended from the
relevant register.
Signing of documents
323
In addition to any other requirements relating to such documents
whether in this Contract or otherwise, the Contractor shall ensure that the
documents specified in clause 324 include –
323.1 the clinical profession of that health care professional who signed
the document; and
323.2 the name of the Contractor on whose behalf it is signed.
324
The documents referred to in clause 323 are-
324.1 certificates issued in accordance with clause 417 unless
regulations relating to a particular certificate provide otherwise;
324.2 prescription forms; and
131
Standard General Medical Services Contract (12.03.04)
324.3 any other clinical documents.
Appraisal and assessment
325.
The Contractor shall ensure that any medical practitioner performing
services under the Contract-
325.1
participates in the appraisal system provided by
the HB unless the practitioner participates in an appropriate
appraisal system provided by another health service body or is an
armed forces GP; and
325.2 co-operates with any assessment process which the HB operates
in relation to poorly performing doctors, as set out in NHS circular
PCA(M)(2001)17.
326.
The HB shall provide an appraisal system for the purposes of clause
325.1 after consultation with the area medical committee and such other persons
as appear to it to be appropriate.
Sub-contracting of clinical matters
327.
Subject to clause 328 the Contractor shall not sub-contract any of its
rights or duties under the Contract in relation to clinical matters unless-
327.1 in all cases, including those which fall within clauses 336 to 350,
it has taken reasonable steps to satisfy itself that it is reasonable in all
the circumstances and that person is qualified and competent to
provide the service; and
132
Standard General Medical Services Contract (12.03.04)
327.2 except in cases which fall within clauses 336 to 350, it has
notified the HB in writing of its intention to sub-contract as soon as
reasonably practicable before the date on which the proposed subcontract is intended to come into force.
328.
Clause 327.2 shall not apply to a contract for services with a health care
professional for the provision by that professional personally of clinical
services.
329.
The notification referred to in clause 327.2 shall include-
329.1 the name and address of the proposed sub-contractor;
329.2 the duration of the proposed sub-contract;
329.3 the services to be covered; and
329.4 the address of any premises to be used for the provision of
services.
330
Following receipt of a notice in accordance with clause 327.2, the HB
may request such further information relating to the proposed sub-contract as
appears to it to be reasonable and the Contractor shall supply such
information promptly.
331
The Contractor shall not proceed with the sub-contract or, if it has
already taken effect, shall take steps to terminate it, where, within 28 days of
the notice referred to in clause 327.2, the HB has served a notice of objection to
the sub-contract on the grounds that-
331.1 the sub-contract would-
133
Standard General Medical Services Contract (12.03.04)
331.1.1
put at serious risk the safety of the Contractor’s patients,
or
331.1.2
put the HB at risk of material financial loss; or
331.2 the sub-contractor would be unable to meet the Contractor’s
obligations under the contract.
332.
Where the HB objects to a proposed sub-contract in accordance with
clause 331, it shall include with the notice of objection a statement in writing
of the reasons for its objection.
333.
Clauses 327, 329 to 332 shall also apply in relation to any renewal or
material variation of a sub-contract in relation to clinical matters.
334.
Where the HB does not object to a proposed sub-contract under clause
331, the parties to the Contract shall be deemed to have agreed to a variation
of the contract which has the effect of adding to the list of practice premises any
premises whose address was notified to it under clause 329.4 and clause 475
shall not apply.
335.
A contract with a sub-contractor must prohibit the sub-contractor from
sub-contracting the clinical services it has agreed with the Contractor to
provide.
Sub-contracting out of hours services48
Clauses 336 to 350 only need to be included in the Contract if the Contractor is providing
out of hours services under the Contract.
48
134
Standard General Medical Services Contract (12.03.04)
336
The Contractor shall not, otherwise than in accordance with the written
approval of the HB, sub-contract all or part of its duty to provide out of hours
services to any person other than those listed in clause 337 other than on a
short-term occasional basis.
337
The persons referred to in clause 336 are-
337.1 a person who holds a general medical services contract, or a
default contract with a HB which includes out of hours services;
337.2 a section 17C provider who is required to provide the equivalent
of essential services to his patients during all or part of the out of hours
period;
337.3
a health care professional, not falling within clause 337.1 to
337.2, who is to provide the out of hours services personally under a
contract for services; or
337.4 a group of medical practitioners, whether in partnership or not,
who provide out of hours services for each other under informal rota
arrangements.
338.
An application for approval under clause 336 shall be made by the
Contractor in writing to the HB and shall state-
338.1 the name and address of the proposed sub-contractor;
338.2 the address of any premises used for the provision of services;
135
Standard General Medical Services Contract (12.03.04)
338.3 the duration of the proposed sub-contract;
338.4 the services to be covered by the arrangement; and
338.5 how it is proposed that the sub-contractor will meet the
Contractor’s obligations under the Contract in respect of the services
covered by the arrangement.
339
Within 7 days of receipt of an application under clause 338, the HB
may request such further information relating to the proposed arrangements
as seem to it to be reasonable.
340
Within 28 days of receipt of an application which meets the
requirements of clause 338 or the further information requested under clause
339 (whichever is the later), the HB shall-
340.1 approve the application;
340.2 approve the application with conditions; or
340.3 refuse the application.
341
The HB shall not refuse
the application
if it is satisfied that the
proposed arrangement will, in respect of the services to be covered, enable the
Contractor to meet satisfactorily its obligations under the Contract and will
not
341.1 put at serious risk the safety of the Contractor’s patients; or
341.2 put the HB at risk of material financial loss.
136
Standard General Medical Services Contract (12.03.04)
342.
The HB shall inform the Contractor by notice in writing of its decision
on the application and, where it refuses an application, it shall include in the
notice a statement of the reasons for its refusal.
343.
Where the HB approves a sub-contract under clause 340 the parties to
the Contract shall be deemed to have agreed a variation of the contract which
has the effect of adding to the list of practice premises , for the purposes of the
provision of services in accordance with that application, any premises whose
address was notified to it under clause 338.2 and clause 475 shall not apply.
344
Clauses 336 to 343
shall also apply in relation to any renewal or
material variation of a sub-contract in relation to out of hours services.
345.
A contract with a sub-contractor must prohibit the sub-contractor from
sub-contracting the out of hours services it has agreed with the Contractor to
provide.
346.
Without prejudice to any other remedies which it may have under the
Contract, where the HB has approved an application made under clause 338 it
shall, subject to clauses 349 and 350, be entitled to serve notice on the
Contractor withdrawing or varying that approval from a date specified in the
notice if it is no longer satisfied that the proposed arrangement will enable the
Contractor to meet satisfactorily its obligations under the Contract.
347.
The date specified pursuant to clause 346 shall be such as appears
reasonable in all the circumstances to the HB.
348.
The notice referred to in clause 346 shall take effect on whichever is the
later of-
348.1 the date specified in the notice; or
137
Standard General Medical Services Contract (12.03.04)
348.2 (if applicable) the date of the final determination of the NHS
dispute resolution procedure (or any court proceedings) relating to the
notice in favour of the HB.
349.
Without prejudice to any other remedies which it may have under the
Contract, where the HB has approved an application made under clause 336 it
shall be entitled to serve notice on the Contractor withdrawing or varying that
approval with immediate effect if-
349.1 it is no longer satisfied that the proposed arrangement will
enable the Contractor to meet satisfactorily its obligations under the
Contract; and
349.2 it is satisfied that immediate withdrawal or variation is
necessary to protect the safety of the Contractor’s patients.
350.
An immediate withdrawal of approval under clause 350 shall take
effect on the date on which the notice referred to in that clause is received by
the Contractor.
Temporary arrangements for transfer of obligations and liabilities in
relation to certain out of hours services49
351
Where the Contractor is required to provide out of hours services under
the Contract pursuant to regulation 30 or 31 of the Regulations, it may, with
the approval of the HB, make an arrangement with one of the persons
specified in clause 354 to transfer the contractor’s obligations under these
regulations.
138
Standard General Medical Services Contract (12.03.04)
352
Any arrangement made pursuant to clause 351 shall cease to have
effect on on the day on which the transferee out of hours services provider ceases
to meet any of the conditions required to provide primary medical services
under the Regulations or on 1st January 2005, whichever is the earlier.
353
An arrangement made in accordance with clause 351 shall, for so long
as it continues relieve the Contractor of-
353.1
its obligations to provide out of hours services pursuant to
the Contract; and
353.2
all liabilities under the Contract in respect of those
services.
354
The persons referred to in clause 351 are-
354.1
a person who holds a general medical services contract, a
section 17C agreement or a default contract with the HB which
includes the provision of out of hours services.
355.
The Contractor may make more than one out of hours arrangement and
may do so (for example) with different contractors or providers of primary
medical services and in respect of different patients, different times and
different parts of its practice area.
356
The Contractor may retain responsibility for, or make separate out of
hours arrangements in respect of, the provision to any patients of maternity
medical services during the out of hours period which the Contractor is required
Clauses 351 to 378 only need to be included in the Contract if the Contractor is providing
out of hours services under the Contract pursuant to Regulations 30 or 31 of the Regulations: see
49
139
Standard General Medical Services Contract (12.03.04)
to provide pursuant to regulation 30 or 31 and any separate out of hours
arrangements it makes may encompass all or any part of the maternity medical
services it provides.
357
Nothing in clauses 351 to 356 shall prevent the Contractor from
retaining or resuming its obligations in relation to named patients.
Application for approval of an out of hours arrangement
358
An application to the HB for approval of an out of hours arrangement
shall be made in writing and shall state-
358.1
the name and address of the proposed transferee out of
hours services provider;
358.2
the periods during which the Contractor’s obligations
under the Contract are to be transferred;
358.3
how the proposed transferee out of hours services provider
intends to meet the Contractor’s obligations during the periods
specified in clause 358.2;
358.4
the arrangements for the transfer of the Contractor’s
obligations under the Contract to and from the transferee out of hours
services provider at the beginning and end of the period specified
under clause 358.2;
358.5
whether
the
proposed
arrangement
includes
Contractor’s obligations in respect of maternity medical services; and
Schedule 6 to the Regulations.
140
the
Standard General Medical Services Contract (12.03.04)
358.6
how long the proposed arrangements are intended to last
and the circumstances in which the Contractor’s obligations under
the Contract during the periods specified in clause 358.2 would revert
to it.
359
The HB shall determine the application before the end of the period of
28 days beginning with the day on which the HB received it.
360
The HB shall grant approval to a proposed out of hours arrangement if it
is satisfied-
360.1
having regard to the overall provision of primary medical
services provided in the out of hours period in its area, that the
arrangement is reasonable and will contribute to the efficient
provision of such services in the area;
360.2
having regard, in particular, to the interests of the
Contractor’s patients, that the arrangement is reasonable;
360.3
having regard, in particular, to all reasonably foreseeable
circumstances that the arrangement is practicable and will work
satisfactorily;
360.4
that it will be clear to the Contractor’s patients how to
seek primary medical services during the out of hours period;
360.5
where maternity medical services are to be provided under
the out of hours arrangement, that they will be performed by a medical
practitioner who has such medical experience and training as are
necessary to enable him properly to perform such services; and
141
Standard General Medical Services Contract (12.03.04)
360.6
that if the arrangement comes to an end, the Contractor
has in place proper arrangements for the immediate resumption of its
responsibilities,
and shall not refuse to grant approval without first consulting the area
medical committee for its area.
361
The HB shall give notice to the Contractor of its determination and,
where it refuses an application, it shall send to the Contractor a statement in
writing of the reasons for its determination.
362
If the Contractor wishes to refer the matter in accordance with the NHS
dispute resolution procedure, it must do so before the end of the period of 30
days beginning with the day on which the HB’s notification under clause 361
was sent.
Effect of approval of an arrangement with a transferee out of hours service
provider
363
If the Contractor acts as a transferee out of hours services provider, in
accordance with an out of hours arrangement approved by the HB in relation to
another Contractor the HB and the Contractor shall be deemed to have agreed
a variation of their contract which has the effect of including in it, from the
date on which the out of hours arrangement commences, and for so long as that
arrangement continues, the services covered by that arrangement, and clause
475 shall not apply.
Review of approval
364
Where it appears to the HB that it may no longer be satisfied of any of
the matters referred to in clauses 360.1 to 360.6, it may give notice to the
142
Standard General Medical Services Contract (12.03.04)
Contractor that it proposes to review its approval of the out of hours
arrangement.
365
On any review under clause 364, the HB shall allow the Contractor a
period of 30 days, beginning with the day on which the HB sent the notice,
within which to make representations in writing to the HB.
366
After considering representations made in accordance with clause 365,
the HB may determine to-
366.1
continue its approval,
366.2
withdraw its approval following a period of notice; or
366.3
if it appears to the HB that it is necessary in the interests
of the Contractor’s patients, withdraw its approval immediately.
367
Except in the case of an immediate withdrawal of approval, the HB
shall not withdraw its approval without first consulting the area medical
committee for its area and where the Health Board determines to withdraw its
approval immediately, it shall notify the area medical committee for its area.
368
The HB shall give notice to the Contractor of its determination under
clause 366.
369
Where the HB withdraws its approval, whether immediately or on
notice, its shall include with the notice a statement in writing of the reasons
for its determination.
143
Standard General Medical Services Contract (12.03.04)
370
If the Contractor wishes to refer the matter in accordance with the NHS
dispute resolution procedure, it must do so before the end of 30 days beginning
with the day on which the HB’s notification under clause 368 was sent.
371
Where the HB determines to withdraw its approval following a period
of notice, the withdrawal shall take effect at the end of the period of two
months beginning with-
371.1
the date on which the notice referred to in clause 369
was sent, or,
371.2
where there has been a dispute which has been referred
under the NHS dispute resolution procedure and the dispute is
determined in favour of withdrawal, the date on which the
Contractor receives notice of the determination.
372
Where the HB determines to withdraw its approval immediately, the
withdrawal shall take effect on the day on which the notice referred to in
clause 368 is received by the Contractor.
Immediate withdrawal of approval other than following review
373
The HB shall withdraw its approval of an out of hours arrangement
immediately-
373.1
in the case of an arrangement with a person referred to in
clause 354.1, if the person with whom it is made ceases to hold a
general medical services contract , a section 17C agreement for the
provision of primary medical services with the HB which includes
the provision of out of hours services; or
144
Standard General Medical Services Contract (12.03.04)
373.2
where, without any review having taken place under
clauses 369 to 372, it appears to the HB that it is necessary in the
interests of the Contractor’s patients to withdraw its approval
immediately.
374
The HB shall give notice to the Contractor of a withdrawal of approval
under clause 373.1 or 373.2 and shall include with the notice a statement in
writing of the reasons for its determination.
375
An immediate withdrawal of approval under clause 373 shall take
effect-
375.1
on the day on which the notice referred to in clause 374 is
received by the Contractor.
376
The HB shall notify the area medical committee for its area of a
withdrawal of approval under clause 373.2.
377
If the Contractor wishes to refer a withdrawal of approval under clause
373.2 in accordance with the NHS dispute resolution procedure, it must do so
before the end of the period of 30 days beginning with the day on which the
HB’s notification under clause 374 was sent.
Termination of an out of hours arrangement
378
The Contractor shall terminate an out of hours arrangement made under
clause 351 with effect from the date of the taking effect of the withdrawal of
the HB’s approval of that arrangement under clauses 364 to 372 or clauses 373
to 377.
145
Standard General Medical Services Contract (12.03.04)
PART 15
RECORDS,
INFORMATION,
NOTIFICATION
AND
RIGHTS
OF
ENTRY50
Patient records
379.
In this part, “computerised records” means records created by way of
entries on a computer.
380.
The Contractor shall keep adequate records of its attendance on and
treatment of its patients and shall do so-
380.1 on forms supplied to it for the purpose by the HB; or
380.2 with the written consent of the HB, by way of computerised
records,
or in a combination of those two ways.
381.
The Contractor shall include in the records referred to in clause 380
clinical reports sent in accordance with clause 38 or from any other health care
professional who has provided clinical services to a person on its list of
patients.
382.
The consent of the HB required by clause 380.2 shall not be withheld
or, once given, withdrawn provided the HB is satisfied, and continues to be
satisfied, thatExcept where it is expressly indicated in a footnote that a particular clause is only required
in certain types of GMS Contract, this section is required by the Regulations: see Part 5 of
Schedule 5.
50
146
Standard General Medical Services Contract (12.03.04)
382.1
the computer system upon which the Contractor proposes to
keep the records has been accredited by the Scottish Ministers or another
person on their behalf as suitable for that purpose in accordance with
“RFA V.1 – Requirements for Accreditation in General Practice Computer
Systems in Scotland”;
382.2 the security measures, audit and system management functions
incorporated into the computer system as accredited in accordance
with clause 382.1 have been enabled; and
382.3 the Contractor is aware of, and has signed an undertaking that it
will have regard to any guidelines issued by the Scottish Ministers and
notified to the contractor by the H B concerning good practice in the
keeping of electronic patient records.
383.
Where a patient’s records are computerised, the Contractor shall, as
soon as possible following a request from the HB, allow the HB to access the
information recorded on the computer system on which those records are
held by means of the audit function referred to in clause 382.2 to the extent
necessary for the HB to check that the audit function is enabled and
functioning correctly.
384.
The Contractor shall send the complete records relating to a patient to
the HB-
384.1 where a person on its list dies, before the end of the period of 14
days beginning with the date on which it was informed by the HB of
the death, or (in any other case) before the end of the period of one
month beginning with the date on which it learned of the death
147
Standard General Medical Services Contract (12.03.04)
384.2 in any other case where the person is no longer registered with
the Contractor, as soon as possible, at the request of the HB
[and the Contractor’s obligations pursuant to this clause, and clause 385
below shall survive the termination or expiry of the Contract]51.
385.
To the extent that a patient’s records are computerised records, the
Contractor complies with clause 384 if it sends to the HB a copy of those
records-
385.1 in written form; or
385.2 with the written consent of the HB in any other form.
386
The consent of the HB to the transmission of information other than in
written form for the purposes of clause 385.2 shall not be withheld or
withdrawn provided it is satisfied, and continues to be satisfied, with the
following matters-
386.1 the Contractor’s proposals as to how the record will be
transmitted;
386.2 the Contractor’s proposals as to the format of the transmitted
record;
386.3 how the Contractor will ensure that the record received by the
HB is identical to that transmitted; and
386.4 how a written copy of the record can be produced by the HB.
148
Standard General Medical Services Contract (12.03.04)
387.
Where the Contractor’s patient records are computerised records, the
Contractor shall not disable, or attempt to disable, either the security
measures or the audit and system management functions referred to in clause
382.2.
Access to records for the purpose of the Quality Information Preparation
Scheme
388.
The Contractor must provide access to its patient records on request to
any appropriately qualified person with whom the HB has made
arrangements for the provision of the Quality Information Preparation
Scheme referred to in section 7 of the GMS Statement of Financial Entitlements.
389.
The Contractor shall not be obliged to grant access to a person referred
to in clause 388 unless that person produces, on request, written evidence that
that person is authorised by the HB to act on its behalf.
Confidentiality of personal data
390.
The Contractor shall nominate a person with responsibility for
practices and procedures relating to the confidentiality of personal data held
by it.
Practice leaflet
391.
The Contractor shall-
The words in square brackets are not mandatory but they are recommended to ensure that
an obligation to provide patient records to the HB continues to apply even where the
Contract has ended.
51
149
Standard General Medical Services Contract (12.03.04)
391.1 compile a practice leaflet which shall include the information
specified in Schedule 3;
391.2 review its practice leaflet at least once in every period of 12
months and make any amendments necessary to maintain its accuracy;
and
391.3 make available a copy of the leaflet, and any subsequent
updates, to its patients and prospective patients.
Provision of information
392.
Subject to clause 393, the Contractor shall, at the request of the HB,
produce to the HB or to a person authorised in writing by the HB or allow it,
or a person authorised in writing by it, to access, on request-
392.1 any information which is reasonably required by the HB for the
purposes of or in connection with the Contract; and
392.2 any other information which is reasonably required in
connection with the HB’s functions.
393.
The Contractor shall not be required to comply with any request made
in accordance with clause 392 unless it has been made by the HB in
accordance with directions relating to the provision of information by
contractors given to it by the Scottish Ministers under section 2(5) of the Act.
Inquiries about prescriptions and referrals
150
Standard General Medical Services Contract (12.03.04)
394.
The Contractor shall, subject to clauses 395 and 396, sufficiently answer
any inquiries whether oral or in writing from the HB concerning-
394.1 any prescription form issued by a prescriber ;
394.2 the considerations by reference to which prescribers issue such
forms;
394.3 the referral by or on behalf of the Contractor of any patient to
any other services provided under the Act; or
394.4 the considerations by which the Contractor makes such referrals
or provides for them to be made on its behalf.
395.
An inquiry referred to in clause 394 may only be made for the purpose
either of obtaining information to assist the HB to discharge its functions or of
assisting the Contractor in the discharge of its obligations under the Contract.
396.
The Contractor shall not be obliged to answer any inquiry referred to
in clause 394 unless it is made-
396.1 in the case of clause 394.1 or 394.2 by an appropriately qualified
health care professional; or
396.2 in the case of clause 394.3 or 394.4, by an appropriately qualified
medical practitioner,
appointed in either case by the HB to assist it in the exercise of its
functions under clause 394 and 395 who produces, on request, written
evidence that the person is authorised by the HB to make such an inquiry
on its behalf.
151
Standard General Medical Services Contract (12.03.04)
Reports to a medical officer
397.
The Contractor shall, if it is satisfied that the patient consents-
397.1 supply in writing to a medical officer within such reasonable
period as that officer, or an officer of the Department for Work and
Pensions on that officer’s behalf and at that officer’s direction, may
specify, such clinical information as the medical officer considers
relevant about a patient to whom the Contractor or a person acting on
the Contractor’s behalf has issued or has refused to issue a medical
certificate; and
397.2 answer any inquiries by a medical officer, or by an officer of the
Department for Work and Pensions on that officers behalf and at that
officers direction, about a prescription form or medical certificate issued
by the Contractor or on the Contrator’s behalf or about any statement
which the Contractor or a person acting on the Contractor’s behalf has
made in a report.
398
For the purpose of satisfying itself that the patient has consented as
required by clause 397, the Contractor may (unless it has reason to believe the
patient does not consent) rely on an assurance in writing from the medical
officer, or any officer of the Department for Work and Pensions, that that
officer holds the patient’s written consent.
Annual return and review
399
The Contractor shall submit an annual return relating to the Contract
to the HB which shall require the same categories of information from all
persons who hold contracts with the HB.
152
Standard General Medical Services Contract (12.03.04)
400
Following receipt of the return referred to in clause 399, the HB shall
arrange with the Contractor an annual review of its performance in relation to
the Contract.
401.
Either the Contractor or the HB may, if it wishes to do so, invite the
area medical committee for the area of the HB to participate in the annual
review.
402.
The HB shall prepare a draft record of the review referred to in clause
399 for comment by the Contractor and, having regard to such comments,
shall produce a final written record of the review. A copy of the final record
shall be sent to the Contractor.
Notifications to the HB
403.
In addition to any requirements of notification elsewhere in the
Contract, the Contractor shall notify the HB in writing, as soon as reasonably
practicable, of-
403.1 any serious incident that, in the reasonable opinion of the
Contractor, affects or is likely to affect the Contractor’s performance of
its obligations under the Contract;
403.2 any circumstances which give rise to the HB’s right to terminate
the contract under clauses 487 and 494;
403.3 any appointments system which it proposes to operate and the
proposed discontinuance of any such system;
153
Standard General Medical Services Contract (12.03.04)
403.4 any change of which it is aware in the address of a registered
patient; and
403.5 the death of any patient of which it is aware.
404.
The Contractor shall, unless it is impracticable for it to do so, notify the
HB in writing within 28 days of any occurrence requiring a change in the
information about it published by the HB in accordance with regulations
made under section 2C(3) of the Act.
405.
The Contractor shall notify the HB in writing of any person other than
a registered patient or a person whom it has accepted as a temporary resident to
whom it has provided the essential services described in clauses 46.3 or 49
within the period of 28 days beginning on the day that the services were
provided.
Notice provision specific to a Contractor that is a company limited by
shares52
406
The Contractor shall give notice in writing to the HB forthwith when-
406.1 any share in the Contractor is transmitted or transferred
(whether legally or beneficially) to another person on a date after the
Contract has come into force;
406.2 it passes a resolution or a court of competent jurisdiction makes
an administration order or an order that the Contractor be wound up;
Clauses 406 and 407 only need to be included in the Contract if the Contractor is a company
limited by shares. If the Contractor is not a company limited by shares, these clauses can be
deleted.
52
154
Standard General Medical Services Contract (12.03.04)
406.3 circumstances arise which might entitle a creditor or a court to
appoint a receiver, administrator or administrative receiver for the
Contractor;
406.4 circumstances arise which would enable the court to make a n
administration order or a winding up order in respect of the
Contractor; or
406.5 the Contractor is unable to pay its debts within the meaning of
section 123 of the Insolvency Act 1986.
407
A notice under clause 406.1 shall confirm that the new shareholder, or,
as the case may be, the personal representative of a deceased shareholder-
407.1 is a medical practitioner, or that the new shareholder, or, as the
case may be, the personal representative of a deceased shareholder, is a
medical practitioner, or satisfies the conditions specified in section
17L(2)(c)(i)to(viii) of the Act; and
407.2 meets the further conditions imposed on shareholders by virtue
of regulations 4 and 5 of the Regulations.
Notice provision specific to a Contractor that is a partnership53
408.
The Contractor shall give notice in writing to the HB forthwith when-
408.1 a partner leaves or informs the other members of the
partnership that the partner intends to leave the partnership, and the
date upon which the partner left or will leave the partnership; and
Clauses 408 and 409 only need to be included in the Contract if the Contractor is a
partnership. If the Contractor is not a partnership, these clauses can be deleted.
53
155
Standard General Medical Services Contract (12.03.04)
408.2 a new partner joins the partnership.
409
A notice under clause 408.2 shall-
409.1 state the date that the new partner joined the partnership;
409.2 confirm that the new partner is a medical practitioner, or that
the partner satisfies the condition specified in section 17L(2)(c)(i) to
(viii) of the Act;
409.3 confirm that the new partner meets the conditions imposed by
regulations 4 and 5 of the Regulations and
409.4 state whether the new partner is a general or limited partner.
Notification of deaths
410.
The Contractor shall report in writing to the HB the death on the
contractor’s practice premises of any patient no later than the end of the first
working day after the date on which the death occurred.
411.
The report shall include-
411.1 the patient’s full name;
411.2 the patient’s National Health Service number where known;
411.3 the date and place of death;
156
Standard General Medical Services Contract (12.03.04)
411.4 a brief description of the circumstances, as known, surrounding
the death;
411.5 the name of any medical practitioner or other person treating
the
patient
whilst
on
the
practice
premises;
and
411.6 the name, where known, of any other person who was present
at the time of the death.
412.
The Contractor shall send a copy of the report referred to in clause 410
to any other HB in whose area the deceased was resident at the time of his
death.
Notifications to patients following a variation of the Contract
413.
Where the Contract is varied in accordance with Part 25 of this
Contract and, as a result of that variation-
413.1 there is to be a change in the range of services provided to the
Contractor’s patients; or
413.2 patients who are on the Contractor’s list of patients are to be
removed from that list,
the HB shall notify those patients in writing of the variation and its effect and
inform them of the steps they can take to obtain elsewhere the services in
question or, as the case may be, register elsewhere for the provision of
essential services (or their equivalent).
Entry and inspection by the HB
157
Standard General Medical Services Contract (12.03.04)
414.
Subject to the conditions in clause 415, the Contractor shall allow
persons authorised in writing by the HB to enter and inspect the practice
premises at any reasonable time.
415
The conditions referred to in clause 414 are that-
415.1 reasonable notice of the intended entry has been given;
415.2 written evidence of the authority of the person seeking entry is
produced to the Contractor on request; and
415.3 entry is not made to any premises or part of the premises used
as residential accommodation without the consent of the resident.
416
Either the Contractor or the HB may, if it wishes to do so, invite the
areal medical committee for the area of the HB to be present at an inspection of
the practice premises which takes place under clause 414.
158
Standard General Medical Services Contract (12.03.04)
PART 16
CERTIFICATES54
417.
The Contractor shall issue free of charge to a patient or his personal
representative any medical certificate of a description prescribed in column 1
of the table below which is reasonably required under or for the purposes of
the enactments specified in relation to the certificate in column 2 of the table
below, except where, for the condition to which the certificate relates, the
patient-
417.1
is being attended by a medical practitioner who is not-
417.1.1
employed or engaged by the Contractor,
417.1.2
if this Contract is with a partnership, one of the partners,
or
417.1.3
if this Contract is with a company limited by shares, one
of the persons legally or beneficially owning shares in the company; or
417.2
is not being treated by or under the supervision of a
health care professional.
418.
The exception in clause 417.1 shall not apply where the certificate is
issued pursuant to regulation 2(1)(b) of the Social Security (Medical Evidence)
Regulations 1976 (which provides for the issue of a certificate in the form of a
54
This Part is required by the Regulations (see regulation 21 and Schedule 3).
159
Standard General Medical Services Contract (12.03.04)
special statement by a doctor on the basis of a written report made by another
doctor ).
LIST OF PRESCRIBED MEDICAL CERTIFICATES
Description of medical certificate
1. To support a claim or to obtain payment
either personally or by proxy; to prove
inability to work or incapacity for selfsupport for the purposes of an award by the
Secretary of State; or to enable proxy to draw
pensions etc.
Short title of enactment under or for the
purpose of which certificate required
Naval and Marine Pay and Pensions Act
1865
Air Force (Constitution) Act 1917
Pensions (Navy, Army, Air Force and
Mercantile Marine) Act 1939
Personal Injuries (Emergency Provisions) Act
1939
Pensions (Mercantile Marine) Act 1942
Polish Resettlement Act 1947
Social Security Administration Act 1992
Social Security Contributions and Benefits
Act 1992
Social Security Act 1998
2. To establish pregnancy for the purpose of
obtaining welfare foods
Section 13 of the Social Security Act 1988
(schemes for distribution etc of welfare
foods)
3. To secure registration of still-birth
Section 21 of the Registration of Births,
Deaths and Marriages (Scotland) Act 1965
(special provision as to registration of stillSection
birth) 142 of the Mental Health Act 1983
(pay, pensions etc. of mentally disordered
persons)
4. To enable payment to be made to an
institution or other person in case of mental
disorder of persons entitled to payment from
public funds.
5. To establish unfitness for jury service
Criminal Procedure (Scotland) Act 1995
Court of Session Act 1988
6.
To support late application for
reinstatement in civil employment or
notification of non-availability to take up
employment owing to sickness.
Reserve
Forces
(Safeguarding
Employment) Act 1985.
160
of
Standard General Medical Services Contract (12.03.04)
7. To enable a person to be registered as an
absent voter on grounds of physical
incapacity
Representation of the People Act 1983
8. To support applications for certificates
conferring exemption from charges in respect
of drugs, medicines and appliances.
National Health Service (Scotland) Act 1978
9. To support a claim by or on behalf of a
severely mentally impaired person for
exemption from liability to pay the Council
Tax or eligibility for a discount in respect of
the amount of Council Tax payable.
Local Government Finance Act 1992.
Schedule 1, paragraph 2(1)(b)
161
Standard General Medical Services Contract (12.03.04)
PART 1755
PAYMENT UNDER THE CONTRACT
419.
The HB shall make payments to the Contractor under the Contract
promptly and in accordance with both the terms of the Contract (including,
for the avoidance of doubt, any payment due pursuant to clause 420) and any
other conditions relating to the payment contained in directions given by the
Scottish Ministers under section 17M of the Act subject to any right the HB
may have to set off against any amount payable to the Contractor under the
Contract any amount-
419.1 that is owed by the Contractor to the HB under the Contract; or
419.2 that the HB may withhold from the Contractor in accordance
with the terms of the Contract or any other applicable provisions
contained in directions given by the Scottish Ministers under section
17M of the Act.
420.
[Subject to clause 421]56 The HB shall make payments to the Contractor
in accordance with directions for the time being in force under section 17M of
the Act. Where, pursuant to directions made under section 17M of the Act, the
HB is required to make a payment to the Contractor under the Contract but
subject to conditions, those conditions are to be a term of the Contract.
421.
[Payments to be made to the Contractor (and any relevant conditions
to be met by the Contractor in relation to such payments) in respect of
services where payments, or the amount of any such payments, are not
55
Part 17 is required by regulations 22 and 23 of the Regulations and section 17M(2) of the Act.
56
The words in square brackets only need to be included if clause 421 is to be included.
162
Standard General Medical Services Contract (12.03.04)
specified in directions pursuant to clause 420, are set out in Schedule 6 to this
Contract.]57
422.
[
]
423.
[
]
424 [
]
425
[
]
426
[
]
427
[
]
428 [
]
Clause 421 needs to be included if, pursuant to the Contract (Parts 8,9 or 11), the
Contractor is providing: additional services that are not funded by the global sum or out of hours services; and/or
 enhanced services
and in either case, the payments to be made in respect of such services, and the conditions
upon which payment is to be made, are not specified in Directions made under section 17M
of the Act. It will also need to be included if there are any other payments to be made, where
the detail of such payments is not specified in directions, for example payments in respect of
premises.
57
163
Standard General Medical Services Contract (12.03.04)
PART 1858
FEES AND CHARGES
429.
The Contractor shall not, either itself or through any other person,
demand or accept from any of its patients a fee or other remuneration for its
own or another’s benefit-
429.1
for the provision of any treatment whether under the
Contract or otherwise, or
429.2
for any prescription for any drug, medicine or appliance,
except in the circumstances set out in clause 430.
430.
The Contractor may demand or accept a fee or other remuneration—
430.1 from any statutory body for services rendered for the purposes
of that body’s statutory functions;
430.2 from any body, employer or school for a routine medical
examination of persons for whose welfare the body, employer or
school is responsible, or an examination of such persons for the
purpose of advising the body, employer or school of any
administrative action they might take;
430.3 for treatment which is not primary medical services or
otherwise required to be provided under the Contract and which is
given58
This Part is required by the Regulations (see regulation 24 and Schedule 4).
164
Standard General Medical Services Contract (12.03.04)
430.3.1
pursuant to the provisions of section 57 of the Act, or
430.3.2
in accommodation provided by a care home service which
is not providing services under the Act
if, in either case, the person providing the treatment is serving on the
staff of a hospital providing services under the Act as a specialist
providing treatment of the kind the patient requires and if, within 7
days of giving the treatment, the Contractor or the person providing
the treatment
supplies the HB, on a form provided by it for the
purpose, with such information about the treatment as it may require;
430.4 under section 158 of the Road Traffic Act 1988 (payment for
emergency treatment of traffic casualties);
430.5 when the contractor treats a patient under clause 431, in which
case it shall be entitled to demand and accept a reasonable fee from the
patient (recoverable in certain circumstances under clause 432) for any
treatment given, if it gives the patient a receipt;
430.6 for attending and examining (but not otherwise treating) a
patient-
430.6.1
at the patient’s request at a police station in connection
with possible criminal proceedings against the patient,
430.6.2
at the request of a commercial, educational or not-for-
profit organisation for the purpose of creating a medical report or
certificate, or
165
Standard General Medical Services Contract (12.03.04)
430.6.3
for the purpose of creating a medical report required in
connection with an actual or potential claim for compensation by the
patient
430.7 for treatment consisting of an immunisation for which no
remuneration is payable by the HB and which is requested in
connection with travel abroad;
430.8 for prescribing or providing drugs or appliances (including a
collection of such drugs and appliances in the form of a travel kit)
which a patient requires to have in his possession solely in anticipation
of the onset of an ailment or occurrence of an injury while he is outside
the United Kingdom but for which he is not requiring treatment when
the medicine is prescribed;
430.9 for a medical examination to enable a decision to be made
whether or not it is inadvisable on medical grounds for a person to
wear a seat belt, or for the purpose of creating a report relating to a
road traffic accident or criminal assault, or that offers an opinion as to
whether a patient is fit to travel;
430.10
for testing the sight of a person to whom none of
paragraphs (a), (b) or (c) of section 26(1) of the Act applies (including by
reason of regulations under section 26(1E)) of that Act);
430.11
where the Contractor is authorised or required by a
Health Board under the contract in accordance with clause 286 to
provide drugs, medicines or appliances to a patient and provides for
that patient, otherwise than under pharmaceutical services, any
Scheduled drug;
166
Standard General Medical Services Contract (12.03.04)
430.12
for
prescribing
or
providing
drugs
for
malaria
chemoprophylaxis.
431
Where a person applies to the Contractor for the provision of essential
services and claims to be on the Contractor’s list of patients, but fails to
produce that person’s medical card on request and the Contractor has
reasonable doubts about that person’s claim, the Contractor shall give any
necessary treatment and shall be entitled to demand and accept a reasonable
fee in accordance with clause 430.5, subject to the provision for repayment
contained in clause 432.
432.
Where a person from whom the Contractor received a fee under clause
430.5 applies to the HB for a refund within 14 days of payment of the fee (or
such longer period not exceeding a month as the HB may allow if it is
satisfied that the failure to apply within 14 days was reasonable) and the HB
is satisfied that the person was on the Contractor’s list of patients when the
treatment was given, the HB may recover the amount of the fee from the
Contractor, by deduction from its remuneration or otherwise, and shall pay
that amount to the person who paid the fee.
433.
Part 18 shall survive the expiry or termination of the Contract59 to the
extent that it prohibits the Contractor from, either itself or through any other
person, demanding or accepting from any patient of it’s a fee or other
remuneration for its own or another’s benefit
433.1 for the provision of any treatment, whether under the Contract
or otherwise, that was provided during the existence of the Contract; or
433.2 for any prescription for any drug, medicine or appliance, that
was provided during the existence of the Contract
59
This clause is not mandatory but it is recommended
167
.
Standard General Medical Services Contract (12.03.04)
168
Standard General Medical Services Contract (12.03.04)
PART 1960
CLINICAL GOVERNANCE
434.
The Contractor shall have an effective system of clinical governance. The
Contractor shall nominate a person who will have responsibility for ensuring
the effective operation of the
system of clinical governance.
The person
nominated shall be a person who performs or manages services under the
Contract.
60
This Part is required by the Regulations (see paragraph 111 of Schedule 5).
169
Standard General Medical Services Contract (12.03.04)
PART 2061
INSURANCE
435.
The Contractor shall at all times hold adequate insurance against
liability arising from negligent performance of clinical services under the
Contract.
436.
The Contractor shall not sub-contract its obligations to provide clinical
services under the Contract unless it is satisfied that the sub-contractor holds
adequate insurance against liability arising from negligent performance of
such services.
437.
For the purposes of clauses 435 to 437.2-
437.1 “insurance” means a contract of insurance or other arrangement
made for the purpose of indemnifying the Contractor; and
437.2 the Contractor shall be regarded as holding insurance if it is
held by an employee of the Contractor in connection with clinical
services which that employee provides under the contract or, as the
case may be, sub-contract.
438.
The Contractor shall at all times hold adequate public liability
insurance in relation to liabilities to third parties arising under or in
connection with the Contract which are not covered by the insurance referred
to in clause 435.
61
This Part is required by the Regulations (see paragraph 112 and 113 of Schedule 5).
170
Standard General Medical Services Contract (12.03.04)
PART 2162
GIFTS
439
The Contractor shall keep a register of gifts which-
439.1
are given to any of the persons specified in clause 440 by,
or on behalf of, a patient, a relative of a patient or any person who
provides or wishes to provide services to the Contractor or its
patients in connection with the Contract; and
439.2
have, in its reasonable opinion, a value of more than
£100.00.
440.
The persons referred to in clause 439 are-
440.1
the Contractor;
440.2
if the Contractor is a partnership, any partner;
440.3
if the Contractor is a company, any person legally and
beneficially holding a share in the company, or a director or secretary
of the company;
440.4
any person employed by the Contractor for the purposes
of the Contract;
440.5
any general medical practitioner engaged by the Contractor
for the purposes of the Contract;
62
This Part is mandatory: see paragraph 114 of Schedule 5 to the Regulations.
171
Standard General Medical Services Contract (12.03.04)
440.6
any spouse of the Contractor (if the Contractor is an
individual medical practitioner) or of a person specified in clauses
440.2 to 440.5; or
440.7
any person (whether or not of the opposite sex) whose
relationship with the Contractor (where the Contractor is an
individual medical practitioner) or with a person specified in clauses
440.2 to 440.5 has the characteristics of the relationship between
husband and wife.
441.
Clause 439 does not apply where-
441.1
there are reasonable grounds for believing that the gift is
unconnected with services provided or to be provided by the
Contractor;
441.2
the Contractor is not aware of the gift; or
441.3
the Contractor is not aware that the donor wishes to
provide services to the Contractor.
442.
The Contractor shall take reasonable steps to ensure that it is informed
of gifts which fall within clause 439 and which are given to the persons
specified in clauses 440.2 to 440.7;
443.
The register referred to in clause 439 shall include the following
information-
443.1
the name of the donor;
172
Standard General Medical Services Contract (12.03.04)
443.2
in a case where the donor is a patient, the patient’s
National Health Service number or, if the number is not known, his
address;
444.
443.3
in any other case, the address of the donor;
443.4
the nature of the gift;
443.5
the estimated value of the gift; and
443.6
the name of the person or persons who received the gift.
The Contractor shall make the register available to the HB on request.
PART 2263
COMPLIANCE WITH LEGISLATION AND GUIDANCE
445.
The Contractor shall comply with all relevant legislation and have
regard to all relevant guidance issued by the HB, and the Scottish Ministers.
63
This Part is required by the Regulations (see paragraph 115 of Schedule 5).
173
Standard General Medical Services Contract (12.03.04)
174
Standard General Medical Services Contract (12.03.04)
PART 2364
COMPLAINTS
Complaints procedure
446.
The Contractor shall establish and operate a complaints procedure to
deal with any complaints in relation to any matter reasonably connected with
the provision of services under the Contract.
447.
The complaints procedure referred to above shall-
447.1
comply with the requirements in clauses 450 to 458, and clause
462;
448.
The Contractor shall take reasonable steps to ensure that patients are
aware of-
448.1 the complaints procedure;
448.2 the role of the HB and other bodies in relation to complaints
about services under the Contract, and
449.
The Contractor shall take reasonable steps to ensure that the
complaints procedure is accessible to all patients.
Making of complaints
64
This Part is required by the Regulations: see Part 6 of Schedule 5.
175
Standard General Medical Services Contract (12.03.04)
450.
A complaint may be made by or, with the patient’s consent, on behalf
of a patient, or former patient, who is receiving or has received services under
the Contract, or
450.1 where the patient is a child-
450.1.1
by either parent, or in the absence of both parents the
guardian or other adult who has care of the child,
450.1.2
by a person duly authorised by a local authority , where
the child is in the care of a local authority under the Children
(Scotland) Act 1995.
450.1.3
by a person duly authorised by a voluntary organisation
by which the child is being accommodated under the provisions of that
Act;
450.2 where the patient is incapable of making a complaint, by a
relative or other adult who has an interest in the patient’s welfare.
451.
Where a patient has died a complaint may be made by a relative or
other adult person who had an interest in the patient’s welfare or, where the
patient fell within clause 450.1.2 or 450.1.3, by the authority or voluntary
organisation, as the case may be.
Period for making complaints
452.
Subject to clause 453, the period for making a complaint is-
452.1 six months from the date on which the matter which is the
subject of the complaint occurred; or
176
Standard General Medical Services Contract (12.03.04)
452.2 six months from the date on which the matter which is the
subject of the complaint comes to the complainant’s notice, provided
that the complaint is made no later than 12 months after the date on
which the matter which is the subject of the complaint occurred.
453
Where a complaint is not made during the period specified in clause
452, it shall be referred to the person nominated in clause 454.1 and if the
person is of the opinion that-
453.1 having regard to all the circumstances of the case, it would have
been unreasonable for the complainant to make the complaint within
that period; and
453.2 notwithstanding the time that has elapsed since the date on
which the matter which is the subject matter of the complaint occurred,
it is still possible to investigate the complaint properly
treat the complaint as if it had been received during the period specified in
clause 452.
Further requirements for complaints procedures
454.
The Contractor shall nominate-
454.1 a person (who need not be connected with the Contractor and
who, in the case of an individual, may be specified by the person’s job
title) to be responsible for the operation of the complaints procedure
and the investigation of complaints; and
177
Standard General Medical Services Contract (12.03.04)
454.2 a partner, or other senior person associated with the Contractor,
to be responsible for the effective management of the complaints
procedure and for ensuring that action is taken in the light of the
outcome of any investigation.
455.
All complaints shall be-
455.1 either made or recorded in writing,
455.2 acknowledged in writing within the period of three working
days beginning with the day on which the complaint was made or,
where that is not possible, as soon as reasonably practicable; and
455.3 properly investigated.
456
Within the period of 10 working days beginning with the day on which
the complaint was received by the person specified under clause 454.1 or,
where that is not possible, as soon as reasonably practicable, the complainant
shall be given a written summary of the investigation and its conclusions.
457.
Where the investigation of the complaint requires consideration of the
patient’s medical records, the person specified under clause 454.1 must
inform the patient or person acting on the patient’s behalf if the investigation
will involve disclosure of information contained in those records to a person
other than the Contractor or an employee of the Contractor.
458.
The Contractor shall keep a record of all complaints and copies of all
correspondence relating to complaints, but such records must be kept
separate from patients’ medical records.
178
Standard General Medical Services Contract (12.03.04)
Co-operation with investigations
459.
The Contractor shall co-operate with-
459.1 any investigation of a complaint in relation to any matter
reasonably connected with the provision of services under the Contract
undertaken by the HB and the Scottish Public Services Ombudsman ;
and
459.2 any investigation of a complaint by an NHS body or local
authority which relates to a patient or former patient of the Contractor.
460.
In the previous clause-
460.1 “NHS body” means, in Scotland, any Health Board in England
and Wales, a Primary Care trust, a NHS trust, a NHS foundation trust, a
Strategic Health Authority, a Local Health Board, and in Northern
Ireland a Health and Social Services Board or a Health and Social Services
Trust; and
460.2 “local authority” means a council constituted under section 2 of
the Local Government etc, (Scotland) Act 1994 (constitution of
councils), any of the bodies listed in section 1 of the Local Authroity
Social Services Act 1970 or the Council of the Isles of Scilly.
461.
In co-operating with any investigation, the Contractor shall, by way of
example,-
461.1 answer questions reasonably put to the Contractor by the HB;
461.2 provide any information relating to the complaint reasonably
required by the HB;
179
Standard General Medical Services Contract (12.03.04)
461.3 attend any meeting to consider the complaint (if held at a
reasonably accessible place and at a reasonable hour, and due notice
has been given) if the Contractor’s presence at the meeting is
reasonably required by the HB.
462.
The Contractor shall inform the HB, at such intervals as required, of
the number of complaints it has received under the procedure established in
accordance with Part 23 of the Contract
463
Part 23 of this Contract shall survive the expiry or termination of the
Contract insofar as it relates to any complaint or investigation reasonably
connected with the provision of services under the contract before it
terminated65.
This clause is not mandatory but it is recommended to ensure that the Contractor is still
under an obligation to comply with the investigation of a complaint or with any relevant
investigation where the Contract has terminated or expired.
65
180
Standard General Medical Services Contract (12.03.04)
PART 2466
DISPUTE RESOLUTION PROCEDURES
Local resolution of contract disputes
464
Subject to clause 466, in the case of any dispute arising out of or in
connection with the Contract, the Contractor and the HB must make every
reasonable effort to communicate and cooperate with each other with a view
to resolving the dispute, before referring the dispute for determination in
accordance with the NHS dispute resolution procedure (or, where applicable,
before commencing court proceedings).
465.
Either the Contractor or the HB may, if it wishes to do so, invite the
area medical committee to participate in discussions which take place pursuant
to clause 464,
466.
In the case of a dispute which falls to be dealt with under the NHS
dispute resolution procedure as modified by paragraph 36(3) of Schedule 5 to the
Regulations, clause 464 does not apply where it is not practicable for the
parties to attempt local resolution before the expiry of the 7-day period
specified in paragraph 91(4) of Schedule 5 to the Regulations as so modified.
Dispute resolution: non-NHS Contracts67
467.
Any dispute arising out of or in connection with the Contract, except
matters dealt with under the complaints procedure set out in clauses 446 to
Except where specifically indicated in the footnotes, this Part is required by the Regulations
(see Part 7 of Schedule 5).
67 These clauses are mandatory terms only if the contract is not an NHS contract. Otherwise,
the clauses should be deleted from the Contract.
66
181
Standard General Medical Services Contract (12.03.04)
462 of this Contract, may be referred for consideration and determination to
the Scottish Ministers, if:
467.1 the HB so wishes and the Contractor has agreed in writing; or
467.2 the Contractor so wishes (even if the HB does not agree).
468.
In the case of a dispute referred to the Scottish Ministers under clause
467, the procedure to be followed is the NHS dispute resolution procedure, and
the parties agree to be bound by a determination made by the adjudicator.
NHS dispute resolution procedure
469.
Subject to clause 470, the NHS dispute resolution procedure applies in the
case of any dispute arising out of or in connection with the Contract which is
referred to the Scottish Ministers in accordance with [Section 17A(4) of the
Act/ clause 467 above]68. and the HB and the Contractor shall participate in
the NHS dispute resolution procedure as set out in paragraphs 91 and 92 of
Schedule 5 to the Regulations.
470.
In the case where the Contractor refers a matter for determination in
accordance with paragraph 36(1)
or 36(2), the procedure specified in
paragraphs 91 and 92 of Schedule 5 to the Regulations
is modified as
mentioned in paragraph 36 of Schedule 5 to the Regulations.
471.
Any party wishing to refer a dispute shall send to the Scottish
Ministers a written request for dispute resolution which shall include or be
accompanied by-
182
Standard General Medical Services Contract (12.03.04)
471.1 the names and addresses of the parties to the dispute;
471.2 a copy of the Contract; and
471.3 a brief statement describing the nature and circumstances of the
dispute.
472.
Any party wishing to refer a dispute as mentioned in clause 469 must
send the request under clause 471 within a period of three years beginning
with the date on which the matter giving rise to the dispute happened or
should reasonably have come to the attention of the party wishing to refer the
dispute.
473.
In clauses 464 to 472 “any dispute arising out of or in connection with
the contract” includes any dispute arising out of or in connection with the
termination of the contract.
474.
Any term of the Contract that makes provision in respect of the
requirements in this Part shall survive even where the Contract has
terminated
If the contract is an NHS contract, the parties must select the phrase “section 17A(4) of the
Act”. If the contract is not an NHS contract, the parties must select the phrase “clause 467
above”.
68
183
Standard General Medical Services Contract (12.03.04)
PART 2569
VARIATION AND TERMINATION OF THE CONTRACT
Variation of the Contract: general
475.
Subject to Part 10 (opts outs of additional and out of hours services),
clauses 85, 334, 343 and 363, and this Part (variation and termination of the
Contract), no amendment or variation shall have effect unless it is in writing
and signed by or on behalf of the HB and the Contractor.
476.
In addition to the specific provision made in clause 512, the HB may
vary the Contract without the Contractor’s consent so as to comply with the
Act, any regulations made pursuant to that Act, or any direction given by the
Scottish Ministers pursuant to that Act where it-
476.1 is reasonably satisfied that it is necessary to vary the Contract in
order so to comply; and
476.2 notifies the Contractor in writing (other than transmission by
electronic means) of the wording of the proposed variation and the
date upon which that variation is to take effect.
477.
Where it is reasonably practicable to do so, the date that the proposed
variation is to take effect shall be not less than 14 days after the date on which
the notice under clause 476.2 is served on the Contractor.
Except where it is indicated in a footnote that a particular provision is only required in
certain types of contract, this Part is required by the Regulations: see Part 8 of Schedule 5.
69
184
Standard General Medical Services Contract (12.03.04)
Termination by agreement
478.
The HB and the Contractor may agree in writing to terminate the
Contract, and if the parties so agree, they shall agree the date upon which that
termination will take effect and any further terms upon which the Contract
should be terminated.
Termination by the Contractor
479.
The Contractor may terminate the Contract by serving notice in writing
on the HB at any time.
480.
[Where the Contractor serves notice pursuant to clause 479, the
Contract shall terminate six months after the date on which the notice is
served (“the termination date”), save that if the termination date is not the last
calendar day of a month, the Contract shall instead terminate on the last
calendar day of the month in which the termination date falls.]70
481.
[Where the Contractor serves notice pursuant to clause 479, the
Contract shall terminate three months after the date on which the notice is
served (“the termination date”), save that if the termination date is not the last
calendar day of a month, the Contract shall instead terminate on the last
calendar day of the month in which the termination date falls.]71
482.
The Contractor may give notice in writing (“late payment notice”) to
the HB if the HB has failed to make any payments due to the Contractor in
accordance with Part 17 of this Contract. The Contractor shall specify in the
This clause should be included where the Contractor is a partnership or a limited company.
Where the Contractor is an individual medical practitioner, this clause should be deleted.
71 This clause should be included where the Contractor is an individual medical practitioner.
Where the Contractor is a partnership or a limited company, this clause should be deleted.
70
185
Standard General Medical Services Contract (12.03.04)
late payment notice the payments that the HB has failed to make in
accordance with Part 17 of the Contract.
483.
The Contractor may, at least 28 days after having served a late
payment notice, terminate the contract by a further written notice if the HB
has still failed to make payments due to the Contractor, and that were
specified in the late payment notice served on the HB pursuant to clause 482.
484.
If, following receipt of a late payment notice, the HB refers the matter
to the NHS dispute resolution procedure within 28 days of the date upon which
it is served with the late payment notice, and it notifies the Contractor in
writing that it has done so within that period of time, the Contractor may not
terminate the Contract pursuant to clause 483 until-
484.1 there has been a determination of the dispute pursuant to
paragraph 92 of Schedule 5 to the Regulations; or
484.2 the HB ceases to pursue the NHS dispute resolution procedure,
whichever is the sooner.
485.
Clauses 479 to 484 are without prejudice to any other rights to
terminate the Contract that the Contractor may have.
Termination by the HB: general provisions
486.
The HB may only terminate the Contract in accordance with the
provisions of Part 25 of this Contract.
Termination by the HB for breach of conditions of regulation 4 of the
Regulations
186
Standard General Medical Services Contract (12.03.04)
487.
The HB shall serve notice in writing on the Contractor terminating the
Contract forthwith if the Contractor is an individual medical practitioner, and
the medical practitioner no longer satisfies the condition specified in
regulation 4(1) of the Regulations.
488.
Where the Contractor is-
488.1 a partnership, and the condition specified in regulation 4(2)(a) of
the Regulations is no longer satisfied; or
488.2 a company limited by shares, and the condition specified in
regulation 4(3)(a) of the Regulations is no longer satisfied
clause 489 shall apply.
489.
Where clause 488.1 or 488.2 applies, the HB shall-
489.1 serve notice in writing on the Contractor terminating the
Contract forthwith; or
489.2 serve notice in writing on the Contractor confirming that the HB
will allow the Contract to continue, for a period specified by the HB of
up to six months (the “interim period”), during which time the HB
shall, with the consent of the Contractor, employ or supply one or
more general medical practitioners to the Contractor for the interim
period to assist the Contractor in the provision of clinical services
under the Contract.
187
Standard General Medical Services Contract (12.03.04)
490.
Before deciding which of the options in clause 489 to pursue, the HB
shall, whenever it is reasonably practicable to do so, consult the area medical
committee for its area.
491.
If the Contractor does not, pursuant to clause 489.2, consent to the HB
employing or supplying a general medical practitioner during the interim
period, the HB shall serve notice in writing on the Contractor terminating the
Contract forthwith.
492.
If, at the end of the interim period, the Contractor still falls within
clause 488.1 or 488.2, the HB shall serve notice in writing on the Contractor
terminating the Contract forthwith.
Termination by the HB for provision of untrue etc information
493.
The HB may serve notice in writing on the Contractor terminating the
contract forthwith, or from such date as may be specified in the notice if, after
this Contract was entered into, it has come to the attention of the HB that
written information provided to the HB by the Contractor before the contract
was entered into in relation to the conditions set out in regulation 4 and 5 of
the Regulations (and compliance with those conditions) was, when given,
untrue or inaccurate in a material respect.
Other grounds for termination by the HB
494.
The HB may serve notice in writing on the Contractor terminating the
Contract forthwith, or from such date as may be specified in the notice if-
494.1 in the case of a contract with a medical practitioner, that medical
practitioner;
188
Standard General Medical Services Contract (12.03.04)
494.2 in the case of a contract with a partnership, any partner or the
partnership; and
494.3 in the case of a contract with a company limited by shares, the
company, any person legally and beneficially owning a share in the
company, or any director or secretary of the company,
falls within clause 495 during the existence of the Contract.
495.
A person falls within this clause if-
495.1 the person does not satisfy the conditions prescribed in section
17L(2)(c) or (3)(b) of the Act;
495.2 the person or it is the subject of a national disqualification;
495.3 subject to clause 496, the person is disqualified or suspended
(other than by an interim suspension order or direction pending an
investigation or a suspension on the grounds of ill-health) from
practising by any licensing body anywhere in the world;
495.4 subject to clause 497, he has been dismissed (otherwise than by
reason of redundancy) from any employment by a health service body
unless before the HB has served a notice terminating the Contract
pursuant to this clause, the person is employed by the health service
body that dismissed the person or by another health service body (and in
this clause “health service body” does not include any person who is to
be regarded as a health service body in accordance with regulation 10 of
the Regulations ) ;
189
Standard General Medical Services Contract (12.03.04)
495.5. the person is disqualified from a list unless the person’sname
has subsequently been included in such a list;
495.6 the person has been convicted in the United Kingdom of murder
495.7 the person has been convicted in the United Kingdom of a
criminal offence, other than of murder, and has been sentenced to a
term of imprisonment of over six months;
495.8 subject to clause 499, the person has been convicted elsewhere of
an offence which would, if committed in Scotland, constitute murder;
or constitute a criminal offence other than murder, and been sentenced
to a term of imprisonment of over six months;
495.9
the person has been convicted of an offence referred to in
Schedule 1 to the Criminal Procedure (Scotland) Act 1995 or Schedule 1
to the Children and Young Persons Act 1933
495.10 the person has-
495.10.1
had sequestration of the person’s estate awarded or been
adjudged bankrupt unless (in either case) the person has been
discharged or the bankruptcy order has been annulled;
495.10.2
been made the subject of a bankruptcy restrictions
order or an interim bankruptcy restrictions order under Schedule 4A to
the Insolvency Act 1986, unless that order has ceased to have effect or
has been annulled
495.10.3
made a composition or arrangement with, or granted a
trust deed for, the person’s creditors unless the person has been
190
Standard General Medical Services Contract (12.03.04)
discharged in respect of it or the person makes any conveyance or
assignation for the benefit of its creditors;
495.10.4
been wound up under Part IV of the Insolvency
act 1986
495.10.5
had an administrator, administrative receiver or receiver
appointed in respect of it;
495.10.6
had an administration order made in respect of it under
Schedule B1 to the Insolvency Act 1986,
495.11
that person is a partnership and-
495.11.1
a dissolution of the partnership is ordered by any
competent court, tribunal or arbitrator, or
495.11.2
an event happens that makes it unlawful for the business
of the partnership to continue, or for members of the partnership to
carry on in partnership;
495.12
495.12.1
the person has been-
removed under section 7 of the Law Reform (Miscellaneous
Provisions) (Scotland) Act 1990 (powers of the Court of Session to deal
with management of charities), from being concerned in the management
or control of any body
495.12.2
removed from the office of charity trustee or trustee for a
charity by an order made by the Charity Commissioners or the High
Court on the grounds of any misconduct or mismanagement in the
191
Standard General Medical Services Contract (12.03.04)
administration of the charity for which the person was responsible or
to which the person was privy, or which the person by the person’s
conduct contributed to or facilitated;
495.13
the person is subject to a disqualification order under the
Company Directors Disqualification Act 1986, the Companies
(Northern Ireland) Order 1986 or to an order made under section
429(2)(b) of the Insolvency Act 1986 (failure to pay under county court
administration order);
495.14.
that person has refused to comply with a request by the
HB for that person to be medically examined on the grounds that it is
concerned that he is incapable of adequately providing services under
the contract and, in a case where the contract is a partnership or with a
company, the HB is not satisfied that the Contractor is taking adequate
steps to deal with the matter;
495.15
the person would otherwise fall within paragraph
113(2)(e) of Schedule 6 to the National Health Service (General Medical
Services Contracts) Regulations 2004.
496.
The HB shall not terminate the Contract pursuant to clause 495.3 where
the HB is satisfied that the disqualification or suspension imposed by a
licensing body outside the United Kingdom does not make the person
unsuitable to be a contractor, a partner, a person legally and beneficially
holding a share in the company, or a director or secretary of the company, as
the case may be.
497.
The HB shall not terminate the Contract pursuant to clause 495.4 until
a period of at least three months has elapsed since the date of the dismissal of
the person concerned; or if, during that period of time, the person concerned
192
Standard General Medical Services Contract (12.03.04)
brings proceedings in any competent tribunal or court in respect of his
dismissal, until proceedings before that tribunal or court are concluded. The
HB may only terminate the Contract in the latter situation if there is no
finding of unfair dismissal at the end of those proceedings.
498
[
]
499.
The HB shall not terminate the Contract pursuant to clause 495.8 where
the HB is satisfied that the conviction does not make the person unsuitable to
be a contractor, a partner, a person legally and beneficially holding a share in
the company, or a director or secretary of the company, as the case may be.
Termination by the HB for a serious breach
500.
The HB may serve notice in writing on the Contractor terminating the
Contract forthwith or with effect from such date as may be specified in the
notice if-
500.1 the Contractor has breached the Contract and the HB considers
that as a result of that breach, the safety of the Contractor’s patients is
at serious risk if the Contract is not terminated; or
500.2 the Contractor’s financial situation is such that the HB considers
that the HB is at risk of material financial loss.
Termination by the HB: remedial notices and breach notices
501.
Where the Contractor has breached the Contract other than as specified
in clauses 487 to 500 and the breach is capable of remedy, the HB shall, before
taking any action it is otherwise entitled to take by virtue of the Contract,
193
Standard General Medical Services Contract (12.03.04)
serve a notice on the Contractor requiring it to remedy the breach (“remedial
notice”).
502
A remedial notice shall specify-
502.1
details of the breach;
502.1
the steps the Contractor must take to the satisfaction of
the HB in order to remedy the breach; and
502.3
the period during which the steps must be taken (“the
notice period”).
503.
The notice period shall, unless the HB is satisfied that a shorter period
is necessary to protect the safety of the Contractor’s patients or protect itself
from material financial loss, be no less than 28 days from the date that notice
is given.
504.
Where the HB is satisfied that the Contractor has not taken the
required steps to remedy the breach by the end of the notice period, the HB
may terminate the Contract with effect from such date as the HB may specify
in a further notice to the Contractor.
505.
Where the Contractor has breached the Contract other than as specified
in clauses 487 to 500 and the breach is not capable of remedy, the HB may
serve notice on the Contractor requiring the contractor not to repeat the
breach (“breach notice”).
506.
If, following a breach notice or a remedial notice, the Contractor-
194
Standard General Medical Services Contract (12.03.04)
506.1
repeats the breach that was the subject of the breach
notice or the remedial notice; or
506.2
otherwise breaches the Contract resulting in either a
remedial notice or a further breach notice,
the HB may serve notice on the Contractor terminating the Contract with
effect from such date as may be specified in that notice.
507.
The HB shall not exercise its right to terminate the Contract under the
previous clause unless it is satisfied that the cumulative effect of the breaches
is such that to allow the Contract to continue would be prejudicial to the
efficiency of the services to be provided under the Contract.
508.
If the Contractor is in breach of any obligation and a breach notice or a
remedial notice in respect of that default has been given to the Contractor, the
HB may withhold or deduct monies which would otherwise be payable under
the Contract in respect of that obligation which is the subject of the default.
Termination by the HB: additional provisions specific to Contracts with
companies limited by shares72
509.
If the HB becomes aware that the Contractor is carrying on any
business which the HB considers to be detrimental to the Contractor’s
performance of its obligations under the Contract-
509.1
the HB shall be entitled to give notice to the Contractor
requiring that it ceases carrying on that business before the end of a
period of not less than 28 days beginning on the day on which the
notice is given (“the notice period”); and
72
If the Contractor is not a company limited by shares, this clause should be deleted.
195
Standard General Medical Services Contract (12.03.04)
509.2
if the Contractor has not satisfied the HB that it has
ceased carrying on that business by the end of the notice period, the
HB may, by a further written notice, terminate the Contract forthwith
or from such date as may be specified in the notice.
Termination by the HB: additional provisions specific to Contracts with a
partnership73
510.
Where the Contractor is a partnership, the HB shall be entitled to
terminate the Contract by notice in writing on such date as may be specified
in that notice where one or more partners have left the practice during the
existence of the Contract if in its reasonable opinion, the HB considers that the
change in membership of the partnership is likely to have a serious adverse
impact on the ability of the Contractor or the HB to perform its obligations
under the Contract.
511.
A notice given to the Contractor pursuant to clause 510 shall specify-
511.1
the date upon which the Contract is to be terminated; and
511.2
the HB’s reasons for considering that the change in the
membership of the partnership is likely to have a serious adverse
impact on the ability of the Contractor or the HB to perform its
obligations under the Contract.
Contract sanctions
512.
73
In clauses 513, 521, 527 and 528, “contract sanction” means-
If the Contractor is not a partnership, this clause should be deleted.
196
Standard General Medical Services Contract (12.03.04)
512.1
termination of specified reciprocal obligations under the
Contract;
512.2
suspension of specified reciprocal obligations under the
Contract for a period of up to six months; or
512.3
withholding or deducting monies otherwise payable
under the Contract.
513
Where the HB is entitled to terminate the Contract pursuant to clauses
493, 494, 500, 504 and 505, it may instead impose any of the contract sanctions
if the HB is reasonably satisfied that the contract sanction to be imposed is
appropriate and proportionate to the circumstances giving rise to the HB’s
entitlement to terminate the Contract.
514
The HB shall not, under clause 513, be entitled to impose any contract
sanction that has the effect of terminating or suspending any obligation to
provide, or any obligation that relates to, essential services.
515.
If the HB decides to impose a contract sanction, it must notify the
Contractor of the contract sanction that it proposes to impose, the date upon
which that sanction will be imposed and provide in that notice an explanation
of the effect of the imposition of that sanction.
516.
Subject to clauses 518 to 521, the HB shall not impose the contract
sanction until at least 28 days after it has served notice on the Contractor
pursuant to clause 514 unless the HB is satisfied that it is necessary to do so in
order to protect the safety of the Contractor’s patients, or protect itself from
material financial loss.
197
Standard General Medical Services Contract (12.03.04)
517.
Where the HB imposes a contract sanction, the HB shall be entitled to
charge the Contractor the reasonable costs of additional administration that
the HB has incurred in order to impose, or as a result of imposing, the
contract sanction.
Contract sanctions and the NHS dispute resolution procedure
518.
If there is a dispute between the HB and the Contractor in relation to a
contract sanction that the HB is proposing to impose, the HB shall not, subject
to clause 521, impose the proposed contract sanction except in the
circumstances specified in clause 519.1 or 519.2.
519.
If the Contractor refers the dispute relating to the contract sanction to
the NHS dispute resolution procedure within 28 days beginning on the date on
which the HB served notice on the Contractor in accordance with clause 515
(or such longer period as may be agreed in writing with the HB), and notifies
the HB in writing that it has done so, the HB shall not impose the contract
sanction unless-
519.1
there has been a determination of the dispute pursuant to
paragraph 92 of Schedule 5 to the Regulations and that determination
permits the HB to impose the contract sanction; or
519.2
the Contractor ceases to pursue the NHS dispute resolution
procedure,
whichever is the sooner.
520.
If the Contractor does not invoke the NHS dispute resolution procedure
within the time specified in clause 519, the HB shall be entitled to impose the
contract sanction forthwith.
198
Standard General Medical Services Contract (12.03.04)
521.
If the HB is satisfied that it is necessary to impose the contract sanction
before the NHS dispute resolution procedure is concluded in order to protect the
safety of the Contractor’s patients or protect itself from material financial loss,
the HB shall be entitled to impose the contract sanction forthwith, pending
the outcome of that procedure.
Termination and the NHS dispute resolution procedure
522.
Where the HB is entitled to serve written notice on the Contractor
terminating the contract pursuant to clauses 493, 494, 500, 504 or 506, the HB
shall, in the notice served on the Contractor pursuant to those clauses, specify
a date on which the Contract terminates that is not less than 28 days after the
date on which the HB has served that notice on the Contractor unless clause
523 applies.
523.
This clause applies if the HB is satisfied that a period less than 28 days
is necessary in order to protect the safety of the Contractor’s patients or
protect itself from material financial loss.
524
In a case falling within clause 522 where the exception in clause 523
does not apply, where the Contractor invokes the NHS dispute resolution
procedure before the end of the period of notice referred to in clause 522, and it
notifies the HB in writing that it has done so, the Contract shall not terminate
at the end of the notice period but instead shall only terminate in the
circumstances specified in clause 525.
525.
The Contract shall only terminate pursuant to this clause if and when
there has been a determination of the dispute pursuant to paragraph 92 of
Schedule 5 to the Regulations and that determination permits the HB to
199
Standard General Medical Services Contract (12.03.04)
terminate the Contract or the Contractor ceases to pursue the NHS dispute
resolution procedure, whichever is the sooner.
526.
If the HB is satisfied that it is necessary to terminate the Contract
before the NHS dispute resolution procedure is concluded in order to protect the
safety of the Contractor’s patients or protect itself from material financial loss,
clauses 524 and 525 shall not apply and the HB shall be entitled to confirm by
written notice to be served on the Contractor, that the Contract will
nevertheless terminate at the end of the period of the notice it served
pursuant to clauses 493, 494, 500, 504 or 506.
Consultation with the area medical committee
527.
Whenever the HB is considering terminating the Contract pursuant to
clauses, 493, 494, 500, 504, 506, 509 or 510 or imposing a contract sanction, it
shall, whenever it is reasonably practicable to do so, consult the area medical
committee for its area before it terminates the Contract or imposes a contract
sanction.
528.
Whether or not the area medical committee has been consulted pursuant
to clause 527, whenever the HB imposes a contract sanction on the Contractor
or terminates the Contract pursuant to this Part, it shall, as soon as reasonably
practicable, notify the area medical committee in writing of the contract sanction
imposed or of the termination of the Contract (as the case may be). The
obligation to notify the area medical committee of the matters set out in this
clause shall survive the termination of the Contract.
Where the contractor changes from being an individual to a partnership74
If the Contractor is not an individual medical practitioner, then this clause does not need to
be included.
74
200
Standard General Medical Services Contract (12.03.04)
529.
Where the Contractor is an individual medical practitioner who
proposes to practise in partnership (“the proposed partnership”)with one or
more persons (“the proposed partners”) and the proposed partners propose
that the proposed partnership should enter into a new contract (“the new
contract”) with the HB on as similar terms as possible to the Contract (“the
old contract”) and as a consequence the Contractor proposes to terminate the
old contract, the Contractor and the proposed partners may give written
notice of those matters to the HB which shall state the information in clause
530 and shall be signed by the Contractor and by the proposed partners as
proposed partners of the proposed partnership.
530.
A notice under clause 529 shall state
530.1 the name and address of the proposed partnership and of the
proposed partners;
530.2 the date on which it is proposed that the partnership should be
formed and become the Contractor, which shall be not less than 28
days after the date upon which it has served the notice on the HB
pursuant to this clause;
530.3 that when the proposed partnership is formed, the requirements
of regulations 4(2) and 5(1)(b) of the Regulations will be satisfied; and
530.4 whether or not the proposed partnership is to be a limited
partnership and, if so, who will be a limited and who a general partner,
531.
If the HB is satisfied as to the accuracy of the matters specified in the
notice referred to in clause 529, the HB shall give notice in writing to the
Contractor and the proposed partners that it is prepared to terminate the old
contract with effect from a specified date and to enter into a new contract with
201
Standard General Medical Services Contract (12.03.04)
the proposed partnership with effect from that date which shall be on the
same terms as the old contract, with only such changes as are necessary to
reflect the fact that the contractor will be a partnership and not an individual
medical practitioner, and the notice shall specify the changes which the
Health Board considers are necessary.
532.
Where it is reasonably practicable, the date specified by the HB
pursuant to clause 531 shall be the date proposed in the notice served by the
Contractor pursuant to clause 529, or, where that date is not reasonably
practicable, the date specified shall be a date after that proposed date that is
as close to it as is reasonably practicable.
533.
If the Contractor and the proposed partners agree with what is
contained in the notice by the HB under clause 531 –
533.1 the HB and the Contractor shall agree in writing to terminate the
old contract with effect from the date specified in that notice; and
533.2 the HB and the partnership shall enter into a new contract with
the HB with effect from that date on the terms mentioned pursuant to
clause 531 but subject to the changes specified in that notice.
534.
Clause 529 to 533 are without prejudice to any other way in which the
old contract may be terminated and a new contract entered into with the
partnership.
Where the contractor changes from being a partnership to an individual75
535.
Where the Contractor is a partnership which it is proposed will
be terminated or dissolved and as a consequence the Contract (“the old
contract”) will be terminated and one of the partners wishes to enter into a
new contract (“the new contract”) with the HB as an individual medical
practitioner (“the proposed contractor”) on as similar terms as possible as
75
If the Contractor is not a partnership, then this clause does not need to be included.
202
Standard General Medical Services Contract (12.03.04)
the old contract, the partnership and the proposed contractor may give
written notice thereof to the HB which shall be signed by the partnership,
the partners in that partnership and the proposed contractor and shall
state -.
535.1 the name and address of the partnership, of the partners in that
partnership and of the proposed contractor;
535.2 that date on which it is proposed that the proposed contractor
should become the contractor, which shall not be less than 28 days
after the date of service of the notice ; and
535.3 that the proposed contractor meets the requirements of
regulations 4(1) and 5(1)(a) .
536.
If the HB is satisfied as to the accuracy of the matters specified in the
notice pursuant to clause 535, it shall give written notice to the partnership
that it is prepared to terminate the old contract with effect from a specified
date; and to enter into a new contract with the proposed contractor with effect
from the date which shall be on the same terms as the old contract, with only
such changes as are necessary to reflect the fact that the Contractor will be an
individual medical practitioner and not a partnership, and the notice shall
specify the changes which the HB consider are necessary.
537.
Where it is reasonably practicable, the date specifed by the HB in the
notice pursuant to clause 536 shall be the date proposed in the notice served
pursuant to clause 535 or, where that date is not reasonably practicable, that
date specified shall be the date after that proposed date that is as close to it as
is reasonably practicable .
203
Standard General Medical Services Contract (12.03.04)
538.
If the partnership and the proposed contractor agree with what is
contained in the notice by the HB pursuant to clause 536-
538.1 the HB and the partnership shall agree in writing to terminate
the old contract with effect from the date specified in that notice; and
538.2 the HB and the proposed contractor shall enter into a new
contract with the HB with effect from that date on the terms mentioned
in clause 536 but subject to the changes specified in that notice.
539.
Clauses 535 to 538 are without prejudice to any other way in which the
old contract may be terminated and a new contract entered into with the
proposed contractor.
Consequences of termination76
540.
The termination of the Contract, for whatever reason, is without
prejudice to the accrued rights of either party under the Contract.
541.
On the termination of the Contract for any reason, the Contractor shall-
541.1
subject to the requirements of this clause, cease
performing any work or carrying out any obligations under the
Contract;
541.2
co-operate with the HB to enable any outstanding matters
under the Contract to be dealt with or concluded in a satisfactory
manner;
The parties are required to make suitable provision for arrangements on the termination of
the Contract (subject to any specific requirements of the Regulations): see regulation 25 of the
Regulations. Subject to this requirement, the parties could draft their own provisions dealing
with the consequences of termination.
76
204
Standard General Medical Services Contract (12.03.04)
541.3
co-operate with the HB to enable the Contractor’s
patients to be transferred to one or more other contractors or
providers of essential services (or their equivalent), which shall
include-
541.3.1
providing reasonable information about individual
patients, and
541.3.22
delivering patient records
to such other appropriate person or persons as the HB specifies.
541.4
deliver up to the HB all property belonging to the HB
including all documents, forms, computer hardware and software,
drugs, appliances or medical equipment which may be in the
Contractor’s possession or control;
542.
Subject to clauses 543 to 545, the HB’s obligation to make payments to
the Contractor in accordance with the Contract shall cease on the date of
termination of the Contract.
543.
On termination of the Contract or termination of any obligations under
the Contract for any reason, the HB shall perform a reconciliation of the
payments made by the HB to the Contractor and the value of the work
undertaken by the Contractor under the Contract. The HB shall serve the
Contractor with written details of the reconciliation as soon as reasonably
practicable, and in any event no later than 28 days after the termination of the
Contract.
544.
If the Contractor disputes the accuracy of the reconciliation, the
Contractor may refer the dispute to the NHS dispute resolution procedure in
205
Standard General Medical Services Contract (12.03.04)
accordance with the terms of the Contract within 28 days beginning on the
date on which the HB served the Contractor with written details of the
reconciliation. The parties shall be bound by the determination of the dispute.
545.
Each party shall pay the other any monies due within three months of
the date on which the HB served the Contractor with written details of the
reconciliation, or the conclusion of the NHS dispute resolution procedure, as the
case may be.
546.
The obligations contained in clauses 540 to 545 shall continue to apply
notwithstanding the termination of the Contract.
206
Standard General Medical Services Contract (12.03.04)
PART 26
NON-SURVIVAL OF TERMS77
547.
Unless expressly provided, no term of this Contract shall survive
expiry or termination of this Contract. Express provision is made in relation
to-
547.1
clauses 384 and 385 (patient records);
547.2
Part 18 (fees and charges);
to the extent specified in
clause 433
547.3
Part 23 (complaints);
547.4
Part 24 (dispute resolution procedures);
547.5
clause 528; (notifications to the area medical committee)
547.6
clauses 540 to 545 (consequences of termination); and
547.7
clauses 550 and 551. (governing law and jurisdiction)
ENTIRE AGREEMENT78
548.
Subject to Part 10 (opts outs of additional and out of hours services),
clauses 334, 343, and 363 and any variations made in accordance with Part 25,
77
78
This clause is not required by the Regulations, but is recommended.
This clause is not required by the Regulations, but is recommended.
207
Standard General Medical Services Contract (12.03.04)
this Contract constitutes the entire agreement between the parties with
respect to its subject matter.
549.
The Contract supersedes any prior agreements, negotiations, promises,
conditions or representations, whether written or oral, and the parties confirm
that they did not enter into the Contract on the basis of any representations
that are not expressly incorporated into the Contract. However, nothing in
this Contract purports to exclude liability on the part of either party for
fraudulent misrepresentation.
GOVERNING LAW AND JURISDICTION79
550.
This Contract shall be governed by and construed in accordance with
Scots law.
551.
Without prejudice to the dispute resolution procedures contained in
this Contract, in relation to any legal action or proceedings to enforce this
Contract or arising out of or in connection with this Contract, each party
agrees to submit to the exclusive jurisdiction of the Scottish courts.
552.
Clauses 550 and 551 shall continue to apply notwithstanding the
termination of the Contract.
WAIVER, DELAY OR FAILURE TO EXERCISE RIGHTS80
553.
The failure or delay by either party to enforce any one or more of the
terms or conditions of this Contract shall not operate as a waiver of them, or
of the right at any time subsequently to enforce all terms and conditions of
this Contract.
79
80
This clause is not required by the Regulations, but is recommended.
This clause is not required by the Regulations, but is recommended.
208
Standard General Medical Services Contract (12.03.04)
FORCE MAJEURE81
554.
Neither party shall be responsible to the other for any failure or delay
in performance of its obligations and duties under this Contract which is
caused by circumstances or events beyond the reasonable control of a party.
However, the affected party must promptly on the occurrence of such
circumstances or events:
554.1
inform the other party in writing of such circumstances
or events and of what obligation or duty they have delayed or
prevented being performed; and
554.2
make all reasonable endeavours to take action within its
power to comply with the terms of this Contract as fully and
promptly as possible.
555.
Unless the affected party takes such steps, clause 554 shall not have the
effect of absolving it from its obligations under this Contract.
For the
avoidance of doubt, any actions or omissions of either party’s personnel or
any failures of either party’s systems, procedures, premises or equipment
shall not be deemed to be circumstances or events beyond the reasonable
control of the relevant party for the purposes of this clause, unless the cause
of failure was beyond reasonable control.
556.
If the affected party is delayed or prevented from performing its
obligations and duties under the Contract for a continuous period of 3
months, then either party may terminate this Contract by notice in writing
within such period as is reasonable in the circumstances (which shall be no
shorter than 28 days).
81
This clause is not required by the Regulations, but is recommended.
209
Standard General Medical Services Contract (12.03.04)
557.
The termination shall not take effect at the end of the notice period if
the affected party is able to resume performance of its obligations and duties
under the Contract within the period of notice specified in accordance with
clause 556 above, or if the other party otherwise consents.
SEVERANCE82
558.
Subject to clauses 559 and 560, if any term of this Contract, other than a
mandatory term, is held to be invalid, illegal or unenforceable by any court,
tribunal or other competent authority, such term shall, to the extent required,
be deemed to be deleted from this Contract and shall not affect the validity,
lawfulness or enforceability of any other terms of the Contract.
559.
If, in the reasonable opinion of either party, the effect of such a deletion
is to undermine the purpose of the Contract or materially prejudice the
position of either party, the parties shall negotiate in good faith in order to
agree a suitable alternative term to replace the deleted term or a suitable
amendment to the Contract.
560.
If the parties are unable to reach agreement as to the suitable
alternative term or amendment within a reasonable period of commencement
of the negotiations, then the parties may refer the dispute for determination in
accordance with the NHS dispute resolution procedure set out in clauses 467 to
474 .
SERVICE OF NOTICE83
82
83
This clause is not required by the Regulations, but is recommended.
This clause is not required by the Regulations, but is recommended.
210
Standard General Medical Services Contract (12.03.04)
561.
Save as otherwise specified in this Contract or where the context
otherwise requires, any notice or other information required or authorised by
this Contract to be given by either party to the other party must be in writing
and may be served:
561.1
personally;
561.2
by post, or in the case of any notice served pursuant to
Part 25, by registered or recorded delivery post;
561.3
by telex, or facsimile transmission (the latter confirmed
by telex or post);
561.4
unless the context otherwise requires and except in clause
475, electronic mail; or
561.5
by any other means which the HB specifies by notice to
the Contractor.
562
Any notice or other information shall be sent to the address specified in
the Contract or such other address as the HB or the Contractor has notified to
the other.
563
Any notice or other information shall be deemed to have been served
or given:
563.1
if it was served personally, at the time of service;
563.2
if it was served by post, two working days after it was
posted; and
211
Standard General Medical Services Contract (12.03.04)
563.3
if it was served by telex, electronic mail or facsimile
transmission, if sent during normal hours then at the time of
transmission and if sent outside normal hours then on the following
working day.
564
Where notice or other information is not given or sent in accordance
with clauses 561 to 563, such notice or other information is invalid unless the
person receiving it elects, in writing, to treat it as valid.
IN WITNESS WHEREOF the parties hereto have caused this Agreement to
be executed on the day and year underwritten by their duly authorised
officers before witnesses:
Signed on behalf of the HB at
Two Thousand and
on the
day of
before the witness hereto subscribing:
Signed
Date
Name
Designation
Witness
Signed
Full Name
Address
Signed on behalf of the Contractor at
Two Thousand and
on the
before the witness hereto subscribing:
Signed
Date
Name
Designation
212
day of
Standard General Medical Services Contract (12.03.04)
Witness
Signed
Full Name
Address
[The Contract must be signed by a person with power to bind the Contractor]
(Note :
Although not a contractual requirement, if the Contractor is a
partnership, it is recommended that all of the partners comprising the
partnership at the date the Contract is signed (whether these partners are
general partners or limited partners) should sign the Contract)
213
Standard General Medical Services Contract (12.03.04)
SCHEDULE 184 (INDIVIDUAL)
Part 1
The HB whose name, address, telephone number, fax number and email
address (if any) is:
Part 2
The Contractor is a medical practitioner whose name, address, telephone
number, fax number (if any) and email address (if any)85 is:
If there is any change to the addresses and contact details specified in Part 1
or Part 2 of this Schedule, the party whose details have changed must give
notice in writing to the other party as soon as is reasonably practicable.
84
85
Please use this form of Schedule if the Contractor is an individual medical practitioner.
Please provide the address to which official correspondence and notices should be sent..
214
Standard General Medical Services Contract (12.03.04)
SCHEDULE 186 (PARTNERSHIP)
Part 1
The HB whose name, address, telephone number, fax number and email
address (if any) is:
Part 2
The Contractor is a [limited]87 partnership under the name of [
]
carrying on business at [address of place of business]
The telephone number, fax number (if any) and email address (if any) of the
Contractor are as follows:-
[insert details here]
If there is any change to the addresses and contact details specified in Part 1
or Part 2 of this Schedule, the party whose details have changed must give
notice in writing to the other party as soon as is reasonably practicable.
The names of the partners at the date of signature of this Contract are:
86
Please use this form of Schedule if the Contractor is a general or limited partnership.
215
Standard General Medical Services Contract (12.03.04)
GENERAL / LIMITED88
GENERAL / LIMITED
GENERAL / LIMITED
GENERAL / LIMITED
GENERAL / LIMITED
GENERAL / LIMITED
GENERAL / LIMITED
The Contract is made with the partnership as it is from time to time
constituted and shall continue to subsist notwithstanding:
(1) the retirement, death or expulsion of any one or more partners; and/or
(2) the addition of any one or more partners.89
The Contractor shall ensure that any person who becomes a partner in the
partnership after the Contract has come into force is bound automatically by
the Contract whether by virtue of a partnership deed or otherwise.
Please delete if this is not applicable. Regulation 11(b)(i) of the Regulations requires that the
Contract specify in the case of a partnership whether or not it is a limited partnership.
88 Please delete whichever is not applicable. Regulation 10(b)(ii) requires that the Contract
specify in the case of a partnership the names of the partners and, in the case of a limited
partnership, their status as a general or limited partner.
89 This provision is required by Regulation 13 of the Regulations.
87
216
Standard General Medical Services Contract (12.03.04)
SCHEDULE 190 (COMPANY)
Part 1
The HB whose name, address, telephone number, fax number and email
address (if any) is:
Part 2
The Contractor is a company limited by shares whose name and registered
office is:
The address to which official correspondence and notices may be sent is, and
the contact telephone number, fax number (if any) and email address (if any)
is:
90
Please use this form of Schedule if the Contractor is a company limited by shares.
217
Standard General Medical Services Contract (12.03.04)
If there is any change to the addresses and contact details specified in Part 1
or Part 2 of this Schedule, the party whose details have changed must give
notice in writing to the other party as soon as is reasonably practicable.
218
Standard General Medical Services Contract (12.03.04)
SCHEDULE 2
NOT ALLOTED
219
Standard General Medical Services Contract (12.03.04)
SCHEDULE 3
INFORMATION TO BE INCLUDED IN PRACTICE LEAFLETS
A practice leaflet shall include—
1. The name of the Contractor.
2. In the case of a Contract with a partnership—
(a) whether or not it is a limited partnership; and
(b) the names of all the partners and, in the case of a limited partnership,
their status as a general or limited partner.
3. In the case of a Contract with a company—
(a) the names of the directors, the company secretary and the
shareholders of that company; and
(b) the address of the company’s registered office.
4. The full name of each person performing services under the Contract.
5.
In the case of each health care professional performing services under the
Contract that person’s professional qualifications.
6.
Whether the Contractor undertakes the teaching or training of health care
professionals or persons intending to become health care professionals.
7.
The contractor’s practice area, by reference to a sketch diagram, plan or
postcode.
8.
The address of each of the practice premises.
9.
The Contractor’s telephone and fax number and the address of its
website (if any).
10. Whether the practice premises have suitable access for all disabled patients
and, if not, the alternative arrangements for providing services to such
patients.
11. How to register as a patient.
12. The right of patients to express a preference of practitioner in accordance
with clause 185 and the means of expressing such a preference.
220
Standard General Medical Services Contract (12.03.04)
13. The services available under the Contract.
14. The opening hours of the practice premises and the method of obtaining
access to services throughout the core hours.
15. The criteria for home visits and the method of obtaining such a visit.
16. The consultations available to patients under clauses 34 and 35, and 36 and
37.
17. The arrangements for services in the out of hours period and how the
patient may contact such services.
18. If the services in paragraph 17 are not provided by the contractor, the fact
that the Health Board referred to in paragraph 26 is responsible for
commissioning the services.
19. The telephone number of NHS 24 and details of the NHS 24 website.
20. The method by which patients are to obtain repeat prescriptions.
21. If the Contractor is a dispensing contractor the arrangements for
dispensing prescriptions.
22. How patients may make a complaint or comment on the provision of
service.
23. The rights and responsibilities of the patient, including keeping
appointments.
24. The action that may be taken where a patient is violent or abusive to the
contractor, its staff or other persons on the practice premises or in the place
where treatment is provided under the Contract or other persons specified in
clause 203.
25. Details of who has access to patient information (including information
from which the identity of the individual can be ascertained) and the patient’s
rights in relation to disclosure of such information.
26. The name, address and telephone number of the HB which is a party to
the contract and from whom details of primary medical services in the area
may be obtained
221
Standard General Medical Services Contract (12.03.04)
222
Standard General Medical Services Contract (12.03.04)
SCHEDULE 4
CLOSURE NOTICE
Application for List Closure
From: Name of Contractor
To: Name of Health Boardt
Date:
In accordance with paragraph 29 of Schedule 5 to the National Health Service (General Medical
Services Contracts) (Scotland) Regulations 2004, on behalf of the above named contractor I/we wish
to make of formal application for our list to be closed to new patients and assignments , as follows:
(1) Length of period of closure (which may not
exceed 12 months and, in the absence of any
agreement, shall be 12 months)
(2) Date from which closure will take effect
(3) Date from which closure will cease to have
effect
(4) Current number of registered patients
(5) Reduction in terms of either percentage of
the number indicated in (4) above or an actual
number of patients which would trigger a reopening (or suspension of list closure) of the
list
(6) Increase in terms of either percentage of the
number indicated in (4) above or actual number
of patients which would trigger a re-closure (or
lifting of the suspension of list closure) of the
list
(7) Any withdrawal or reduction of additional
or enhanced services
Signed…………………………………………………………………………………...
For [Name of contractor]
223
Standard General Medical Services Contract (12.03.04)
SCHEDULE 5
PLAN FOR IMPROVEMENT OF PREMISES
224
Standard General Medical Services Contract (12.03.04)
SCHEDULE 6
PAYMENT SCHEDULE
225